This document discusses the management of inguinal hernias. It notes that hernias can be managed conservatively or surgically, with surgical management being the gold standard. The main surgical repair procedures discussed are herniotomy, herniorraphy, and hernioplasty. Laparoscopic surgery techniques like TEP and TAPP are also summarized. Potential intraoperative, early, and late complications of hernia repair are listed.

1. MANAGEMENT OF INGUINAL
HERNIA
AYESHA HUMA
MBBS 4TH YEAR
2K16 , SIMS

3. ❌NOT CURATIVE JUST TO PREVENT
COMPLICATIONS IN SICK PATIENT
INDICATION :
• Patient with comorbidities where
surgery can’t be performed.
• Reducible hernia
CONTRAINDICATIONS :
• Irreducible hernia
• Undescedent testis
CONSERVATIVE MANAGEMENT

4. SURGICAL MANAGEMENT

5. INDICATIONS OF REPAIR PROCEDURES
HERNIOTOMY HERNIORAPHY HERNIOPLASTY
All pediatrics patients &
Young adults.
• Indication : Congenital hernia &
Congenital hydrocele (PPPV )
Young adults with good muscle
tone
Weak posterior wall
Old age poor muscle tone
& young patients also
As Child is growing the Inguinal
canal & muscles are growing
therefore we can’t tie the muscles
or place a mesh
Dilated internal ring Direct hernia
Huge indirect hernia
GOLD STANDARD FOR HERNIA
REPAIR

15. LAPAROSCOPIC SURGERY
TOTAL EXTRAPERITONEAL
REPAIR ( TEP )
• Popular than TAPP
• ADV : Avoid creating
pneumoperitoneum ( decrease
risk of bowel injury & adhesion )
• DISADV : Small working space
therefore done by experienced
surgeon
• Commonly done
TRANS ABDOMINAL PERIPERITONEAL
(TAPP )
• Create pneumoperitoneum
• ADV : Large working space can
be done by begginers.
• DisADV : increase risk of damage
to adjacent structures
✔️ During TAPP take consent to
repair if hernia is seen on opp side
as working space is huge it can be
visible

16. COMPLICATIONS
INTRAOPERATIVE EARLY LATE
1. Injury to blood vessels ( Inf
epigastric & femoral )
2. Injury to nerves ( II & IH )
1. Urine retention
2. Hematoma
3. Infection
1. Recurrence
2. Obstruction
3. Testicular atrophy if testicular
artery Is damaged
3. Injury to bowel & bladder
4. Injury to cord structures
4. Periosteitis of public tubercle
5. Post HERNIORAPHY hydrocele
6. Seroma