Surg Clin North Am. Dec;78(6) Inguinal hernia repair. The Nyhus posterior preperitoneal operation. Patiño JF(1), García-Herreros LG, Zundel N. The Nyhus Posterior Preperitoneal Operation The repair of inguinofemoral hernias constitutes the most widely performed general surgical procedure. Adapted with permission from Nyhus LM, Klein MS, Rogers FB. Inguinal hernia. Curr Probl Surg ;
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Instead, they are acquired by the development of tissue deficiencies of the transversus abdominis muscle, which makes up the floor of the inguinal canal. N Engl J Med.
Purchase access Subscribe now. Today, most laparoscopic herniorrhaphies are performed using either the transabdominal preperitoneal TAPP approach or the total extraperitoneal TEP approach.
Thus, an indirect hernia is the result of two conditions: Type III—posterior wall defects. Rutkow and Robbins Read the full article. Posterior repair iliopubic tract repair and Nyhus technique is performed by dividing the layers of the abdominal wall superior to the internal ring and entering the properitoneal space.
When performed by skilled surgeons, these repairs provide reliable, satisfactory results and have similar recurrence rates.
Recurrence rates in these cases have been reported to be 3 percent or henias. This article reviews the available surgical options for herniorrhaphy and the possible complications of these procedures. It is the first edition not edited by the original authors, Nyhus and Condon.
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Inguinal hernia repair. The Nyhus posterior preperitoneal operation.
Get free access to newly published articles. The major nerves in the inguinal region are the ilioinguinal, iliohypogastric and genitofemoral nerves.
This breakdown may occur because of incomplete dissection, poor tissue quality longstanding large hernias or the patient’s too-rapid return to daily activities. Global anatomy of the pelvis and inguinal trigone. Sign in to hernas free article PDFs Sign in to access your subscriptions Sign in to your personal account.
Recurrence is the most common long-term complication of inguinal herniorrhaphy. At present, the major drawbacks nyhuus laparoscopic herniorrhaphy are the cost of the laparoscopic equipment, the need for general anesthesia and the absence of long-term follow-up data.
Note the lush innervation of this region. More in Pubmed Citation Related Articles. Either general or regional spinal anesthesia may be used in these patients.
A critical evaluation of the Lichtenstein tension-free hernioplasty. Except for pain or a dull dragging sensation in the groin, the common reducible inguinal hernia usually does not cause significant symptoms. The reported recurrence rates for surgically treated hernias vary widely, depending on the length and diligence of the follow-up period. When the potential complications of incarceration and strangulation are weighed against the minimal risks of hernia repair particularly when local anesthesia is usedthe early repair of groin hernias is clearly justified.
However, indirect and direct hernias need to be differentiated during surgery, because the approach to repair depends on the defect type.
Surgical Options in the Management of Groin Hernias
However, it may be difficult to identify this problem in patients with scarring from a previous repair. The figures are well crafted, and the color plates are excellent.
Studies conducted at nonspecialty centers probably provide a more accurate view of hernia repair techniques and results.
Purchase access Subscribe to the journal. Excellent results have been achieved with this approach, and reported recurrence rates have been less than 1 percent. Laparoscopic mesh repair, viewed from inside the pelvis toward the direct and indirect sites. Most nerve entrapment syndromes are self-limited, respond to nonsteroidal analgesics and resolve with time.
In contrast, tension-free repair using mesh, as well as other types of hernia repair, may be comfortably and safely completed with patients receiving only local anesthesia. See My Options close Already a member or subscriber? Continue reading from January 1, Previous: A hernia that is not repaired appropriately is more likely to recur.
The male-to-female ratio is 9: Most laparoscopic hernia repairs are being performed by skilled laparoscopic surgeons in specialty centers.