Hernia Flashcards
What is reducibility?
Can be pushed back, and it comes out only when counter force is applied on cough/strain (seen in uncomplicated hernia)
What is compressibility?
When the swelling return spontaneously once the pressure to reduce it is removed . seen in vascular surgery like hemangioma or lymphangioma
What is obstructed hernia/incarcerated hernia
Occurs when the contents show obstruction but the blood supply is NormaL
Obstructed hernia is
Irreducible that means there is no cough impulse
What is strangulated hernia?
Obstructed + compromised blood supply . skin changes are seen
In uncomplicated hernia process of reduction/taxis is best
Left to the patient
Based on the content in the sac, what are the two types
Omentocele and enterocele
What would you feel on palpation of omentocele?
Doughy consistency ; easy to reduce first part ; difficult to reduce second part.
What would you feel on palpation of enterocele?
Difficult to reduce first part easy to reduce second part
In the Omentocele if the content is Meckel’s diverticulum, it is called as
Litter’s hernia
In the Omentocele if the content is Appendix, it is called as
Amyand hernia
What are the steps of herniotomy ?
- Identify the sac
- Open the sac.
- Push the contents.
- Cut the excess sac.
- Close the sac.
(Highest recurrence rate)
Herniotomy is treatment of choice is
Congenital inguinal, hernia and congenital hydrocele
What is herniorrhaphy?
Step 12345+ suture the two adges of the defect together
What is the most common cause of failure of herniorrhaphy
Increase tension in the repair
What are the techniques of herniorrhaphy?
Bassini’s ;
Shouldice ;
Mayo / kell
What is the indication of herniorrhaphy
Infected/strangulated hernia’s
What is hernioplasty?
Step 12345+ put a mesh over the defect to repair it. It has leased the current state.
Which technique is used in hernioplasty?
Lichenstein’s tension free mesh hernioplasty
Which mesh is avoided when there is an infection
Synthetic
Example of synthetic mesh
Vipro : vicryl + Prolene &
PTFE
Example of Biological mesh
Alloderm ; Acellular procine dermis
Ideal mesh is
Low weight mesh ;
Thin fibers ;
Large pores
What is meshoma
Excessive collagen deposition in plug mesh ; nerves get entrapped leading to pain