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Surg Clin North Am. Dec;78(6) Inguinal hernia repair. The Nyhus posterior preperitoneal operation. Patiño JF(1), García-Herreros LG, Zundel N. A hernia is an outpouching of the parietal peritoneum through a preformed or secondarily established hiatus. If the hernia Table Ib. Nyhus hernia classification. Adapted with permission from Nyhus LM, Klein MS, Rogers FB. Inguinal hernia. Curr Probl Surg ;

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Use nyhua local anesthesia also avoids the respiratory and immune depressive effects of general anesthesia. An exception are acquired umbilical hernias, that may occur in patients with acute abdominal distension. Average of 9 months range: With overinguinal hernia operations per year in the USA, inguinal hernia repair is the most common operation for general nybus 6.

Patients with such injuries present with pain in the groin and thigh. The need of an extended preparation of the subfacial space lead to a higher rate of postoperative bleeding and hematomas. Table II Methods of hernia repair. The main management procedure is high ligation of the hernial sac.

The hernial orifice is in the muscles of the lumbar area. Tension-free repair can be performed using any type of anesthesia. In some series, the laparoscopic approach has been 40 percent more costly than other approaches.


The posterior preperitoneal approach. The larger ones usually readily reducible, whereas the smaller ones often became in-carcerated. Correlating with the repair of inguinal hernias, many different operative techniques for incisional hernia have been introduced, most recently laparoscopic procedures. Several studies 89 have found that, with proper preoperative preparation, more than 90 percent of groin hernias can be repaired with patients receiving only a local anesthetic.

Finally, these approaches can be particularly effective in patients with hernia recurrence after traditional open herniorrhaphy. Average of 4 years range: The writing is rich with details herniaa illustrations.

If the hernia extends beyond the abdominal cavity and is thus visible on the surface of the body, it is defined as an external hernia. Note the lush innervation of this region. Hyhus the recent development of new meshes an additional group should be added: The triangle is outlined in red.

Symptoms and Complications To what extent a hernia represents a disease entity rarely depends on the fact of the hernia itself, but rather on the fate of hernial contents. Incarceration is common, especially in smaller hernias, but strangulation is unusual.

Most classification systems take into account the location of the defect direct, indirect or femoralthe size of the defect and whether or not the herniation is recurrent. The development of femoral herniation is not well hernoa. Support Center Support Center. Register for email alerts with links to free full-text articles Access PDFs of free articles Manage your interests Save searches and receive search alerts.


Nyhus and Condon’s Hernia | JAMA Surgery | JAMA Network

The symptoms vary considerably, including abdominal pain, a mass in the anterior abdominal wall or signs of incarceration with or without intestinal obstruction. Our website uses cookies to enhance your experience. In the following decades until today many modifications concerning material and other textile structure have been introduced.

Results of a multicenter trial. N Engl J Med. Pathogenesis The pathogenesis of hernias is multifactorial.

Surgical Options in the Management of Groin Hernias

Rutkow and Robbins Surgical repair of a hernia is not warranted in terminally ill patients with no evidence of incarceration.

It may be palpable near the femoral ring or in the medial thigh.

National Center for Biotechnology InformationU. Reviewed by Mary MurrayMD.

Early in the development of the technique, hernias were repaired by placing a large piece of mesh over the entire inguinal region on top of the peritoneum. Definition A hernia is an hernka of the parietal peritoneum through a preformed or secondarily established hiatus. Injury to the genital branch of the genitofemoral nerve can cause hypersensitivity of the groin, scrotum and upper thigh, and can be associated with ejaculatory dysfunction.