What is Hernia?
A hernia usually happens when an organ squeeze through an opening in the muscle or tissue that holds it set up. For instance, the intestines may get through a debilitated zone in the abdominal wall.
Several types of hernias happen in the abdomen between your chest and hips, yet they can likewise show up in the upper thigh and crotch or groin area.
Most hernias aren't promptly life-threatening, yet they don't leave all alone. Here and there they can require Hernia Surgery to forestall dangerous complexities.
2. • Ahernia is defined as an abnormal protrusion of an organ or
tissuethroughadefect initssurrounding walls.
• Groinhernia
• Inguinal
• Direct
• Indirect
• femoraL
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6. • Theinguinal canal is anoblique space measuring 4
cm in length that lies above themedial half of the
inguinal ligament.
• Inguinal canal has 4 walls : anterior, posterior, roof, and
floor
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10. • Males : spermatic cord and ilioinguinal nerve
• Females : round ligament and the ilioinguinal nerve
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12. • Uncomplicated hernias requireeither :
• No treatment
• Support with atruss
• Operativetreatment
• complicated hernias :
• always requiresurgery
, oftenurgently
.
13. • For any hernia the surgical option comprises 2components:
• Herniotomy
• Herniorrhaphyor hernioplasty
• It is either :
•Openrepair
Bassini repair
Shouldice repair
T
ensionfreemesh repair
• Laparascopicrepair
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20. • Bilateral inguinal hernia
• Whenthe diagnosis of inguinal hernia is uncertain
•Whenthe patient want to return to normal physical life
Laparoscopic repair is done by 2approaches :
1. Transabdominal preperitoneal “TAPP”
2. T
otally extraperitoneally “TEP”
21. • Thepatient medical condition makes general
anesthesia more risky
• Patient who have planned pelvic or extraperitoneal
operations (eg, radical prostatectomy)
• Patient who havehad arecurrence fromaprior
laparoscopic repair
• Patient presented with strangulated hernia
22. • Less acutepostoperative
pain
• Shorter convalescence
• Earlier returntowork
DISADVANTAGES
• increased riskof femoral
nerveinjury and
• Increased riskof spermatic
corddamage
• risk of developing
intraperitoneal adhesions
withtheT
APP
• greater cost and durationof
theoperation
23. • The T
APPapproach, first described by Arregui and
colleagues in 1992
• It requires laparoscopic access into the peritoneal
cavity and placement of mesh in the preperitoneal
space after reducing the hernia sac.
24. • The first TEPinguinal hernia repair was described by
McKernan and Laws in1993.
• This approach involves preperitoneal dissection and
mesh placement without entering into the abdominal
cavity.
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