Inguinal Hernia Flashcards
What percentage of men will develop an inguinal hernia in their lifetimes?
25%
What are the three types of inguinal hernias?
Indirect, direct, femoral
What is the reason for inguinal hernias in pediatric population?
Patent processus vaginalus
What is the most likely reason for an inguinal hernia in the adult population?
Widening of internal inguinal ring
What anatomic structure differentiates indirect from direct inguinal hernias?
Inferior epigastric vessels
What type of hernia is more common in women?
Femoral hernia
What physical exam finding allows for differentiation of femoral hernia from direct/indirect inguinal hernias?
Bulge is detected in medial thigh or below inguinal ligament
What were the findings of the VA watchful waiting study?
Watchful waiting in asymptomatic hernia patient does not result in increased morbidty and mortality
Of patients who undergoing watchful waiting, what percent will become symptomatic in 2 years time?
25%
What are the three most common tissue repairs?
Bassini, McVay and Shouldice
What does the Bassini repair entail?
Suturing Bassini’s triple layer (internal oblique muscle, transversus abdominis muscle, and transversalis fascia) to the iliopubic tract/inguinal ligament
What does the McVay repair entail?
Similar to Bassini, but medial portion utilizes cooper’s ligament rather than inguinal ligament
What does the Shouldice repair entail?
Same as Bassini but in layers, using continuous suture
Where is the relaxing incision in a tissue repair made?
On rectus fascia
What is the Lichtenstein repair?
“Tension-Free” repair using mesh
What is the recurrence rate for tissue repairs?
10%
How many laparoscopic hernia repairs are needed to become proficient?
250
What is the most common type of inguinal hernia repair in the US?
Plug and patch
Post-operative pain after an inguinal hernia repair will usually resolve in how many months?
6-12 months
When should a patient with post-operative pain after an inguinal hernia repair be taken back to the OR immediately?
When it is in the distribution of one of the nerve branches and starts immediately post-op
What is a contraindication to laparoscopic hernia repair?
Previous prostatectomy
What is a sports hernia?
Weak posterior inguinal floor and entrapment of nerves due to muscle tears at muscle insertion on pubis
