hernia repair
{{Short description|Surgical procedures to fix abnormal openings through which tissue or organs may protrude}}
{{Infobox medical intervention (new)
| name = Hernia repair
| synonyms =
| image = Surgical staples3.jpg
| caption = Surgical incision at the groin after inguinal herniorrhaphy
| alt =
| pronounce =
| specialty = General surgery
| uses =
| complications =
| approach =
| types = Herniorrhaphy, hernioplasty
| recovery time =
| other options =
| outcomes =
| frequency =
| cost =
}}
Hernia repair is a surgical operation for the correction of a hernia—a bulging of internal organs or tissues through the wall that contains it. It can be of two different types: herniorrhaphy; or hernioplasty.{{Cite news|url=https://offlineclinic.com/difference-between-herniorraphy-and-hernioplasty-for-hernia-repair/|title=Difference between herniorraphy and hernioplasty for hernia repair - Offline Clinic|date=2012-10-28|newspaper=Offline Clinic|access-date=2017-02-10|language=en-US}} This operation may be performed to correct hernias of the abdomen, groin, diaphragm, brain, or at the site of a previous operation. Hernia repair is often performed as an ambulatory procedure.
Techniques
=Inguinal hernia repair=
{{main|Inguinal hernia repair}}
The first differentiating factor in hernia repair is whether the surgery is done open, or laparoscopically. Open hernia repair is when an incision is made in the skin directly over the hernia. Laparoscopic hernia repair is when minimally invasive cameras and equipment are used and the hernia is repaired with only small incisions adjacent to the hernia. These techniques are similar to the techniques used in laparoscopic gallbladder surgery.{{cn|date=January 2022}}
An operation in which the hernia sac is removed without any repair of the inguinal canal is described as a herniotomy. When herniotomy is combined with a reinforced repair of the posterior inguinal canal wall with autogenous (patient's own tissue) or heterogeneous material such as prolene mesh, it is termed hernioplasty as opposed to herniorrhaphy, in which no autogenous or heterogeneous material is used for reinforcement.{{Citation needed|date=June 2011}}
=Stoppa procedure=
The Stoppa procedure is a tension-free type of hernia repair. It is performed by wrapping the lower part of the parietal peritoneum with prosthetic mesh and placing it at a preperitoneal level over Fruchaud's myopectineal orifice. It was first described in 1975 by Rene Stoppa.{{cite journal |vauthors=Stoppa R, Petit J, Henry X |title=Unsutured Dacron prosthesis in groin hernias |journal=Int Surg |volume=60 |issue=8 |pages=411–412 |year=1975 |pmid=125731}} This operation is also known as "giant prosthetic reinforcement of the visceral sac" (GPRVS).{{cite journal |author=Wantz G |title=Giant prosthetic reinforcement of the visceral sac |journal=Surg Gynecol Obstet |volume=169 |issue=5 |pages=408–417 |year=1989 |pmid=2814751}}
This technique has met particular success in the repair of bilateral hernias, large scrotal hernias, and recurrent or rerecurrent hernias in which conventional repair is difficult and which carries a high morbidity and failure rate.{{cite journal |vauthors=Lowham A, Filipi C, Fitzgibbons R, Stoppa R, Wantz G, Felix E, Crafton W |title=Mechanisms of hernia recurrence after preperitoneal mesh repair. Traditional and laparoscopic |journal=Ann Surg |volume=225 |issue=4 |pages=422–431 |year=1997 |pmid=9114802 |doi=10.1097/00000658-199704000-00012 |pmc=1190751}} The most recent reported recurrence rate (involving 230 patients with 420 hernias and a maximum of 8 years follow-up) was 0.71%.{{cite journal |vauthors=Maghsoudi H, Pourzand A |title=Giant prosthetic reinforcement of the visceral sac: the Stoppa groin hernia repair in 234 patients |journal=Ann Saudi Med |volume=25 |issue=3 |pages=228–232 |year= 2005|pmid=16119524|pmc=6147995 |doi=10.5144/0256-4947.2005.228 }} The totally extra-peritoneal repair (TEP) uses exactly the same principles as the Stoppa repair, except that it is performed laparoscopically.{{cite journal |vauthors=Beets G, Dirksen C, Go P, Geisler F, Baeten C, Kootstra G |title=Open or laparoscopic preperitoneal mesh repair for recurrent inguinal hernia? A randomized controlled trial |journal=Surg Endosc |volume=13 |issue=4 |pages=323–327 |year=1999 |pmid=10094739 |doi=10.1007/s004649900981|s2cid=228152 }}
= Advancements in Hernia Repair =
Robotic-assisted hernia repair has gained popularity due to its precision, smaller incisions, and quicker recovery times. Using robotic systems, surgeons have greater flexibility and control during the procedure. Although its use is still more expensive and requires specialized equipment, early studies suggest that robotic hernia repair may offer improved outcomes in complex cases, such as large or recurrent hernias.{{Citation |last=Bianco |first=Francesco M. |title=Robotic Assisted Morgagni Hernia Repair |date=2019 |work=Robotic Assisted Hernia Repair |pages=445–456 |url=http://dx.doi.org/10.1007/978-3-030-23025-8_29 |access-date=2024-11-25 |place=Cham |publisher=Springer International Publishing |isbn=978-3-030-23024-1 |last2=Pavelko |first2=Yevhen |last3=Gangemi |first3=Antonio}}
References
{{Reflist}}
External links
- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2719730/?tool=pubmed European Hernia Society guidelines on the treatment of inguinal hernia in adult patients.]
- [http://americanherniasociety.org/ American Hernia Society]
- [http://www.shakahara.com/hernia/surgery_methods.html Surgery Methods, Inguinal Hernia, Description, Comparison] {{Webarchive|url=https://web.archive.org/web/20110629102126/http://shakahara.com/hernia/surgery_methods.html |date=2011-06-29 }}
{{Medical resources
| ICD10 =
| ICD9 = {{ICD9proc|53}}
| MeshID =
}}
{{Digestive system surgical procedures}}