Hernias

Question 1

T or F:
A hernia is defined as the protrusion of a tissue or organ through a defect in the wall of the anatomical cavity in which it normally lies.

Answer 1

True, yo.

Question 2

Traumatic hernias are INITIALLY _______ hernias.

Answer 2

False hernias (lack hernial sac)

Question 3

Principles of Herniorrhaphy (repairing hernia)

[4]

Answer 3

1. Return contents to normal location
2. Secure ring closure
3. Tension free closure (esp when we have not a lot of tissue, lot of tension—> could lead to dehiscence)
4. Utilize patient tissues

Question 4

What suture material do we use for Herniorrhaphy?

Answer 4

Usually absorbable (usu. in body cavity/under skin)
Consider type of hernia, condition of patient (altered wound healing due to diabetes would get nonabsorbable, etc.)

Question 5

Umbilical hernias are a failure of fusion of which muscle at the umbilicus?

Answer 5

Rectus abdominis m.

Question 6

How do we treat umbilical hernias?

Answer 6

Small (<3mm) or large (>2.5cm) —> little risk of strangulation; treat conservatively

Size of intestines in sm/med dog—> increased risk for strangulation; repair!

Question 7

Inguinal hernias are direct when they occur through inguinal _____, but are INdirect when they occur through ______________.

Answer 7

Musculature;

Vaginal ring (I.e. scrotal hernia)

Question 8

How do we surgically approach inguinal hernias?

Answer 8

Female: ventral midline - can correct both sides
Males: inguinal approach directly over hernia

One layer closure of both rings

Question 9

Approach for acute abdominal hernia repair?

Answer 9

Ventral midline; enables exploration of abdomen and repair any organ injury

Question 10

Suture/patterns for acute abdominal hernia repair?

Answer 10

2/0 monofilament

Tension relieving pattern (horizontal/vertical mattress)

Question 11

Approach for chronic abdominal hernia repair?

Answer 11

Can do ventral midline, but could also just approach over hernia (better anatomic closure and less likely concurrent injuries)

Question 12

What is the important patient positioning in prepubic tendon/cranial pubic ligament ruptures?

Answer 12

Dorsal recumbent with hind legs in frog leg position with pelvis raised on towels/sand bags

Question 13

What type of suture do we use for prepubic tendon/ cranial pubic ligament repair?

Answer 13

Nonabsorbable

Question 14

What is the onset for an ACUTE incisional hernia?

Answer 14

Within 7 days of surgery (most 3-5)

Question 15

Type of hernia involving weakness and separation of the pelvic diaphragm components?

Answer 15

Perineal hernia

Question 16

Most common type of perineal hernia?

Answer 16

Caudal (levator ani, external anal sphincter, internal obturator)

Question 17

What muscles do we use in the traditional Herniorrhaphy?

Answer 17

Levator ani and coccygeus mm.