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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Perineal Hernia Perineal hernias are primary or secondary herniations of the pelvic floor that appear para- or retrorectally between the levator ani and coccygeal muscles. Seven steps to local anesthesia for inguino femoral hernia repair.

The therapy is always surgical. Early studies uernia acceptable outcomes for laparoscopic herniorrhaphy may reflect the same bias other procedure-focused centers have shown for open herniorrhaphy. Jan 1, Issue.

Nyhus and Condon’s Hernia, 5th Edition

Staples are not nyhud in proximity to neurovascular structures. Nyhus and Condon’s Hernia. Recurrence is the most common long-term complication of inguinal herniorrhaphy. Purchase access Subscribe to the journal. Inguinal hernias are bilateral in as many as 20 percent of affected adults.

Create a free personal account to make a comment, download free article PDFs, sign up for alerts and more. Local anesthesia alone does not allow for comfortable and technically optimal herniorrhaphy in patients with a very high anxiety level.

Create a free personal account to access your subscriptions, sign up for alerts, and more. They present with a flank protrusion, that rarely results in a strangulation, but increases in size and therefore should undergo surgical repair at the time of discovery. Support Center Support Center. In the managed-care environment, elective herniorrhaphy is under increasing pressure.


Based on operative intent and approach, the many different herniorrhaphy techniques can be grouped into four main categories. Surgical Options in the Management of Groin Hernias.

Surgical Options in the Management of Groin Hernias

Reasons for an acute elevation of the intra-abdominal pressure include ascites from cirrhosis, congestive heart failure or nephrosis. Transabdominal preperitoneal laparoscopic repair. Compared with other types of hernia repair, laparoscopic herniorrhaphy is significantly more expensive.

All tension-free hernia repair techniques with mesh have shown excellent results without statistical proof of the superiority of any single method. Most hernias can be diagnosed based on the history and clinical examination, but ultrasonography may be useful in differentiating a hernia from other causes of groin swelling.

It may be palpable near the femoral ring or in the medial thigh. Please review our privacy policy. Patients with such injuries present with pain in the groin and nghus.

The group 3 hernia repairs Lichtenstein and Rutkow techniques use the same initial approach as open anterior repair. Thus, these hernias protrude directly through a defect in the inguinal canal floor, rather than indirectly following the potential space of the processus vaginalis and the path of the spermatic cord.

Joachim ConzeUwe Klingeand V. Performance of the laparoscopic TAPP repair also exposes patients to potential intra-abdominal injury and late adhesion formation. First description was made by Arnaud de Villeneuve inbut it was not until that the term epigastric hernia was introduced by Leveille. Several studies have demonstrated that this approach is safe and involves only minimal use of pain medication.

Average of 9 months range: Hernias usually present as swelling accompanied by pain or a dragging sensation in the groin. This content is owned by the AAFP. While these syndromes are often self-limited, surgery has been necessary to remove the staples that caused the neuralgia.


Create a free personal account to download free article PDFs, sign up for alerts, and more. It is probably best performed with the patient receiving regional or general anesthesia. Metabolic disorders such as obesity, renal insufficiency, diabetes and deficiency nnyhus protein, coagulation factor VIII or vitamin C have also an impairment on the wound healing, smoking as well as certain medications, such as steroids and chemotherapeutic agents.

Sign in to customize your interests Sign in to your personal account. The genital branch of the genitofemoral nerve travels within the spermatic cord to provide sensation to the scrotum and the medial thigh. Heernia, the hernia sac content is preperitoneal fatty tissue. In contrast, tension-free repair using mesh, as well as other hhernia of hernia repair, may be comfortably and safely completed with patients receiving only local anesthesia.

Global anatomy of the pelvis and inguinal trigone. When they case symptoms, they are almost always incarcerated, usually on the right side and often combined with a femoral hernial. Long-term mesh migration with arrosion of neighboring structures e.

Nyhus and Condon’s Hernia

Copyright American Medical Association. Nyuus recurrence rate following this relatively new technique cannot as be completely assessed, but it has been reported to be less than 4 percent. If the outpouching is limited to peritoneal pockets, it is known as an internal hernia.