Hernia

Question 1

Direct inguinal herniaare _ to the inferior epigastrics

Answer 1

Direct Medial

Question 2

Direct hernia are from weakness in the _ fascia

Answer 2

transversalis

Question 3

70 M s/p >Lichtenstein repair of the right inguinal hernia, POD 10 with fever, leukocytosis, and purulent discharge.
What is dx?

Answer 3

Prosthetic mesh infection

Question 4

which structure is routinely incised during Nissen?

Answer 4

Incise the short gastrics

Question 5

Tx for parastomal hernia`

Answer 5

1. Sugarbaker - underlay repair with th stoma exiting laterally btw the mesh and peritoneum
2. keyhole made in the mesh and encircled around the stoma to cover the defect

Question 6

posterior boundary of the femoral cnala

Answer 6

pectineal (coopers) ligament

Question 7

wihc surgical intervention will lead to the lowest chance of an inguinal hernia recurrence?

Answer 7

Lichtenstein repair or lap preperitoneal reapir w mesh

Question 8

the ilioinguinal nerve is located over _

Answer 8

spermatic cord

Question 9

which struc ture injured qhen sewing on shelvimg edge?

Answer 9

External Iliac vein

Question 10

Which is shown to reduce the risk of recurrence afteringuinal hernia repair with mesh

Answer 10

crossing the tails of the mesh posterior to the spermatic cord to avoid recurrence lateral to the internal ring

Question 11

femoral hernia boundaries

Answer 11

Cooper;s ligament posteriorly, iliopubic tract anteriorly and femoral vein laterally

Question 12

steps for component seperation

Answer 12

1. skin and subQ elevatedfrim underlying rectus and external oblique fascia extending from costal to pubis to and enterior axillary line
2. incision 2cm lateral from borderrectus from costal to iguinal ligament
3. the external oblique isbluntly dissected of internal (gets5 cm upper, 10 middle and 3 lower)
4. if not sufficient,the rectus can be dissected free from posterior sheath