Surg Clin North Am. Dec;78(6) Inguinal hernia repair. The Nyhus posterior preperitoneal operation. Patiño JF(1), García-Herreros LG, Zundel N. The Nyhus Posterior Preperitoneal Operation The repair of inguinofemoral hernias constitutes the most widely performed general surgical procedure. Adapted with permission from Nyhus LM, Klein MS, Rogers FB. Inguinal hernia. Curr Probl Surg ;

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Reviewed by Mary MurrayMD. Sonography may be useful in diagnosing inguinal hernias in patients who report symptoms but do not have a palpable defect.

Bilateral hernias may also be addressed simultaneously, using either an open or a laparoscopic procedure.

Already a member or subscriber? Early results for laparoscopic surgery are promising, but information on long-term outcomes is currently unavailable. The femoral vein also runs just deep to the inguinal floor laterally. This advantage is particularly important in elderly and frail patients.

An indirect hernia passes lateral to the inferior epigastric vessels and thus is outside of Hesselbach’s triangle Figure 2while a direct hernia is medial to the epigastric vessels and therefore within the confines herias this space Figure 3.

Patients with ascites generally should not undergo elective herniorrhaphy until their ascites is controlled.

Sign in to make a comment Sign in to your personal account. Please review our privacy policy. This advantage appears to be most notable in patients who do heavy manual labor.


Inguinal hernia repair. The Nyhus posterior preperitoneal operation.

Inguinal hernias are broadly jernias as indirect or direct, designations that refer to the relation of the herniation to the inferior epigastric arteries on the abdominal wall and the Hesselbach’s triangle.

Several studies have demonstrated that this approach is safe and nyhud only minimal use of pain medication. Patients with such injuries present with pain in the groin and thigh. Address correspondence to Brett C. Mesh plug hernia repair: The male-to-female ratio is 9: In the managed-care environment, elective herniorrhaphy is under increasing pressure.

Nyhus and Condon’s Hernia

Average of 4 years range: Nyhus and Condon’s Hernia. Type II—indirect inguinal hernia. In patients who have symptoms suggestive of recurrent herniation but no clinical findings, the diagnosis can usually be herhias through sequential serial examinations and the judicious use of imaging modalities.

Use of local anesthesia also avoids the respiratory and immune depressive effects of general anesthesia. Most early inguinal hernias can be diagnosed by careful physical examination.

Inguinal hernia repair in adults. Except for pain or a dull dragging sensation in the groin, the common reducible inguinal hernia usually does not cause significant symptoms.

Surgical Options in the Management of Groin Hernias – – American Family Physician

While it is often difficult to differentiate hernial types preoperatively, a consistent approach to classifying hernias during surgery can provide information that will allow institutions to compare the outcomes achieved with different types of hernia repair. This approach was abandoned because of the potential for small-bowel obstruction and fistulae development caused by the exposure of bowel to mesh.

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While these syndromes are often self-limited, surgery has been necessary to remove the staples that caused the neuralgia. Hrnias convalescence also contributes to absence from the work force.

This book is in readable print and reflects recent advances in a field significantly affected by research, the use of prostheses, and minimally invasive surgery. This allows the mesh to be placed and then covered with peritoneum. The techniques in the open anterior repair group differ somewhat in their approach to reconstruction, but they all use permanent sutures to approximate the surrounding fascia and repair the floor of the inguinal canal.

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Again, all are very well written and henrias with information regarding repair and management. In addition, they require general anesthesia, and the long-term hernia recurrence rate with these procedures is unknown. Information from references 7and 15 through