Inguinal Hernia Flashcards

1
Q

What percentage of men will develop an inguinal hernia in their lifetimes?

A

25%

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2
Q

What are the three types of inguinal hernias?

A

Indirect, direct, femoral

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3
Q

What is the reason for inguinal hernias in pediatric population?

A

Patent processus vaginalus

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4
Q

What is the most likely reason for an inguinal hernia in the adult population?

A

Widening of internal inguinal ring

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5
Q

What anatomic structure differentiates indirect from direct inguinal hernias?

A

Inferior epigastric vessels

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6
Q

What type of hernia is more common in women?

A

Femoral hernia

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7
Q

What physical exam finding allows for differentiation of femoral hernia from direct/indirect inguinal hernias?

A

Bulge is detected in medial thigh or below inguinal ligament

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8
Q

What were the findings of the VA watchful waiting study?

A

Watchful waiting in asymptomatic hernia patient does not result in increased morbidty and mortality

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9
Q

Of patients who undergoing watchful waiting, what percent will become symptomatic in 2 years time?

A

25%

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10
Q

What are the three most common tissue repairs?

A

Bassini, McVay and Shouldice

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11
Q

What does the Bassini repair entail?

A

Suturing Bassini’s triple layer (internal oblique muscle, transversus abdominis muscle, and transversalis fascia) to the iliopubic tract/inguinal ligament

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12
Q

What does the McVay repair entail?

A

Similar to Bassini, but medial portion utilizes cooper’s ligament rather than inguinal ligament

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13
Q

What does the Shouldice repair entail?

A

Same as Bassini but in layers, using continuous suture

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14
Q

Where is the relaxing incision in a tissue repair made?

A

On rectus fascia

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15
Q

What is the Lichtenstein repair?

A

“Tension-Free” repair using mesh

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16
Q

What is the recurrence rate for tissue repairs?

A

10%

17
Q

How many laparoscopic hernia repairs are needed to become proficient?

A

250

18
Q

What is the most common type of inguinal hernia repair in the US?

A

Plug and patch

19
Q

Post-operative pain after an inguinal hernia repair will usually resolve in how many months?

A

6-12 months

20
Q

When should a patient with post-operative pain after an inguinal hernia repair be taken back to the OR immediately?

A

When it is in the distribution of one of the nerve branches and starts immediately post-op

21
Q

What is a contraindication to laparoscopic hernia repair?

A

Previous prostatectomy

22
Q

What is a sports hernia?

A

Weak posterior inguinal floor and entrapment of nerves due to muscle tears at muscle insertion on pubis