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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A hemilateral scrotal enlargement in a 5-month-old Hampshire ram lamb was diagnosed as a scrotal hernia. Surgical intervention revealed the herniation to involve only the omentum, with some testicular atrophy. The cause of this condition was thought to be trauma.
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PMID:Unilateral scrotal hernia repair in a ram lamb. 405 76

Development of herniography as a diagnostic tool has reopened the question of whether the asymptomatic groin should be explored at the time of unilateral herniorrhaphy in infants. In an attempt to provide data toward the formulation of an answer, the authors review 32 yr of experience with 160 infant hernias. They represent a sequential, unselected series of pediatric patients whose hernias were repaired only if confirmed by examination, and whose postoperative fate has been assessed over extended periods of time. Ninety-six percent of the group were able to be evaulated over an average follow-up interval of 20 yr. It was discovered that of the total group of children with hernias, 29% developed a hernia on the opposite side at some time in their lives. The chance of contralateral occurrence was found not to vary with the child's age at time of first repair, but was found to depend on which side the original repair involved; if the first repair was on the left, the child's chance of contralateral involvement was 41%; if on the right, the risk was only 14%. Morbidity was insignificant with the notable exception of testicular atrophy, which occurred in 2% of the group. The authors conclude that despite the 29% overall risk of future contralateral development, bilateral exploration is not justified for two reasons: First, that a number of unnecessary procedures would be performed, two operations to prevent each subsequent right-sided hernia, and six operations to preclude each later left-sided occurrence; Second, that the risk of bilateral testicular trauma, though slight, is too great.
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PMID:The unilateral pediatric inguinal hernia: Should the contralateral side by explored? 738 67

Two of the most important etiological factors in the development of primary and recurrent inguinal hernias are collagen deficiency and tension on the suture line respectively. These factors can be eliminated by the use of open "tension-free" hernioplasty, advocated by the Lichtenstein Hernia Institute since 1984. In this procedure, the entire floor of the inguinal canal is reinforced by an 8 cm x 16 cm sheet of Marlex mesh that is sutured in place to protect the floor from all future adverse mechanical and metabolic effects without the risk of displacement or folding. A new ring and shutter mechanism is also created by the procedure, which is performed under local anesthesia and requires only a few hours of in-hospital postoperative observation. Pain control following the operation involves only 2-20 tablets of 5 mg hydrocodone bitartrate, for 2-4 days. The recurrence rate of early procedures was a mere 0.1%, and has been zero for 2,500 patients treated in the past five years. In addition, there has only been one complication (a testicular atrophy) in 4,000 operations over ten years. The postoperative pain and recovery period of the "tension free" procedure compare favorably with those of laparoscopic repair, while the complication and recurrence rate and costs are significantly lower. The Lichtenstein "tension-free" method has been performed on tens of thousands of patients worldwide and these results have been duplicated and published by authors from the United States, England, Belgium, Spain, Italy and Austria.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:An analytic comparison of laparoscopic hernia repair with open "tension-free" hernioplasty. 765 3

Over a 6-year period, 14 infants with a total of 16 inguinal hernias (IH) underwent transperitoneal closure of the internal ring (TPIR). This was performed through a minilaparotomy, using a purse-string suture placed around the internal ring from within. A difficult inguinal dissection of an edematous and friable spermatic cord was avoided. TPIR was performed for incarceration in 13 of the infants and for recurrence of the hernia within 24 hours of herniotomy in one. There were no intraoperative problems, and during follow-up there was no evidence of testicular atrophy or recurrence of the hernia. This suggests that TPIR is a reliable and safe operation in babies for whom the alternative inguinal approach would be difficult. These situations include hernias that are irreducible and early recurrence in which dissection of the cord would risk damage to the vas deferens or testicular vessels.
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PMID:Transperitoneal closure of the internal ring in incarcerated infantile inguinal hernias. 772 40

Over a period of 6 years, 251 infants under 6 months of age underwent repair of inguinal hernias (IH; n = 311). There were 241 males and 10 females. Incarceration occurred in 59 infants (24%), one of whom had bilateral incarceration. As a result of the authors' policy to operate on infantile IH within 7 days of diagnosis, only 6% of the incarcerations occurred in already diagnosed cases. Sedation and taxis did not reduce the hernia in 22 cases (38%); transperitoneal closure of the internal ring was performed in 14 of these. Eighty-nine infants (36%) were born premature; thirty-nine (41%) of these had been ventilated before, a possible cause of the hernia. Bilateral presentation was more common in the premature infants (35% v 17%); surprisingly, incarceration was less common (13% v 24%). Hence, the policy of delaying herniotomy until discharge from the neonatal unit was justified. During follow-up, six recurrences were noted and two cases of testicular atrophy.
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PMID:Inguinal herniotomy in young infants, with emphasis on premature neonates. 784 31

The original Bassini and Shouldice methods for inguinal herniorrhaphy were tested against each other and against their respective variants that avoid permanent suturing of the internal oblique muscle. Seven hundred fifty inguinal hernia repairs were prospectively allocated to 1 of 4 groups: group A: Bassini with absorbable sutures (polyglycolic acid); group B: Bassini with nonabsorbable sutures (polyester); group C: Shouldice with four rows of polypropylene sutures; and group D: Shouldice with two rows of polypropylene sutures. Outcome was correlated to prospectively defined types and risk factors such as direct hernia, repair for recurrent hernia, hernial sac diameter greater than 8 cm, age greater than 70 years, overweight, and chronic bronchitis. Actual (not actuarial) recurrence rates were determined through clinical examination by hospital staff surgeons (not through information by letter or phone) for 93.6% of surviving patients. Local complications exclusive of recurrence, but including the redoubtable and litigious sequelae of testicular atrophy and chronic ilioinguinal pain, were significantly reduced from 6.3% (group B and C) to 2.3% by omitting permanent muscle sutures (groups A and D; P < 0.05). However, the use of slowly absorbable suture material resulted in a disproportionately high recurrence rate of 12.8% in the modified Bassini group A. The original Bassini method, ie, division of the transversalis fascia and repair with nonabsorbable sutures, as was used in group B, had an actual 2-year recurrence rate of 8.7%, still a highly significant difference compared with 3.6% and 2.3% for Shouldice groups C and D, respectively (P = 0.012). For repair of recurrent hernia, the superiority of the Shouldice technique was not statistically significant: re-recurrence rate 7.6% versus 13.5% for the original Bassini group B. Repair of recurrent hernia was the only patient-related risk factor of equal significance as the method of repair. The Shouldice technique is superior to and more than merely a reinvention of Bassini's original method. The omission of muscle sutures is physiologically sound and recommended for the Shouldice operation.
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PMID:Shouldice is superior to Bassini inguinal herniorrhaphy. 802 92

This retrospective study reviews 211 patients having sustained a bilateral groin hernia repair during a 3 year period. The procedure was the same for all the patients: via a Pfannensteil approach, a pre peritoneal prosthetic repair is performed, using two ePTFE patches, after resection of the hernial sacs and closure of the parietal gaps. The mean follow up was 2 years. During the post operative course, thirty seven of 211 patients sustained 10 local complications, 9 urethral catheter related complications and 11 residual pain. No prostheses infection or testicular atrophy was observed. Nine patients had recurrences (2.2% of 422 repairs). All the recurrences were due to incorrect technique, eight were successfully re operated on--Expanded PTFE is a reliable prosthetic material, easy to handle and well adapted to preperitioneal hernia repair.
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PMID:[Treatment of bilateral inguinal hernia by subperitoneal prosthetic parietoplasty. Value of PTFE]. 807 1

While classical inguinal hernia repair has recently been brought up for discussions among surgeons, at present various modified techniques are being reintroduced in general surgery. Surgical hernia repair techniques which partly are known since several decades are being carried out laparoscopically since 1989. Between August 1992 and June 1993, the authors performed 52 laparoscopic inguinal hernia repairs using the preperitoneal placement of nonresorbable mesh. There were no intraoperative complications. Merely one patient had an abdominal wall hematoma at the site of a trocar which resolved spontaneously. All patients have been followed up for 3-13 months. To date, all postoperative check ups revealed no recurrences, testicular atrophy or paresthesia. Even though little can yet be said regarding long-term results especially about recurrences, laparoscopic preperitoneal hernia repair seems to be a promising surgical procedure concerning early postoperative results.
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PMID:[Laparoscopic hernia surgery]. 814 50

Between 1973 and 1985, 165 infants (aged 1 week to 6 months) underwent unilateral inguinal herniotomy at our hospital. An attempt was made to trace these 165 children. It proved possible to contact and examine 116 children (104 boys and 12 girls). Age at follow-up ranged from 5 to 17 years. Parents were asked whether their children had attended any hospital for the treatment of contralateral hernia. All children were examined for the evidence of contralateral hernia. Boys were also examined for the position and size of the testis. Testicular volume was assessed with the help of Prader's Orchidometer. Twelve children (10.3%), 11 boys and 1 girl, subsequently developed contralateral inguinal hernia. The mean time interval between initial hernia operation and subsequent development of contralateral hernia was 164 days (range, 7 days to 18 months). Diminished size of testes was observed on the side of the operation in six patients and one patient had complete testicular atrophy. Three boys had a testis in the groin, presumably hitched up at operation and all three required orchidopexy. In view of the relatively low incidence of contralateral hernia and increased risk of damage to testes, we feel that routine contralateral exploration is not justified.
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PMID:Is contralateral exploration necessary in infants with unilateral inguinal hernia? 822 90

We report on the early and late complications after hernia repair in this retrospective study. Over a period of five years, 920 adult men underwent Bassini-Kirschner repair for inguinal hernia as first operation. There occurred six hematomas (0.6%), 11 seromas (1.2%) and 10 wound infections (1.0%). There were no deaths. 781 patients were controlled after two to seven years. We found recurrence of inguinal hernia in 15 cases (1.9%), chronic inguinal pain in 29 cases (3.7%), testicular atrophy in two cases (0.2%).
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PMID:[Bassini-Kirschner inguinal hernia surgery--follow-up of 781 primary operations in adult men]. 825 30


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