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- •Management of Abdominal Hernias
- •Preface
- •Preface to the Third Edition
- •Contents
- •The Dawn of Anesthesia
- •Contributors
- •1: General Introduction and History of Hernia Surgery
- •Ancient and Renaissance Hernia Surgery
- •The Anatomical Era
- •The Era of Antisepsis and Asepsis
- •The Technological Era
- •The Extraperitoneal–Preperitoneal Approach to the Groin
- •Two Europeans: Lytle and Fruchaud
- •Inguinal Hernias in Soldiers in Georgian England
- •Winston Churchill’s Hernia Repair
- •Tension-Free Hernia Repair
- •Laparoscopic Repair
- •Chronology of Hernia Surgery
- •References
- •2: Essential Anatomy of the Abdominal Wall
- •External Anatomy: Surface Markings and Surface Features
- •Skin
- •The Subcutaneous Layer
- •Super fi cial Nerves
- •Musculoaponeurotic Plane
- •The Rectus Abdominis Muscle
- •The External Oblique Muscle
- •The Internal Oblique Muscle
- •The Transverse Abdominal Muscle
- •The Conjoint Tendon
- •The Linea Alba and the Rectus Sheath and its Contents
- •Innervation and Blood Supply of the Muscles of the Anterior Abdominal Wall
- •Function of the Anterior Abdominal Wall
- •The Fascia Transversalis: The Space of Bogros
- •The Peritoneum: The View from Within
- •The Umbilicus
- •The Spermatic Cord
- •Comparative Anatomy
- •Radiological Anatomy
- •References
- •3: Epidemiology and Etiology of Primary Groin Hernias
- •Epidemiology
- •Demand for Groin Hernia Surgery in Adults
- •Inguinal Hernias in Adults
- •Femoral Hernias in Adults
- •Etiology of Primary Groin Hernia
- •Hernias “Under the Microscope”
- •A Curious Case of Recurrent Recurrence
- •Genetics in Pediatric Surgical Practice
- •The Genetics of Inheritance of the “Common” Indirect Inguinal Hernia
- •Intra-abdominal Diseases Causing Hernias
- •Inguinal Hernia and Appendectomy
- •Hernias Related to Trauma and Pelvic Fracture
- •Exertion and Groin Herniation
- •Conclusions
- •References
- •4: Logistics
- •Introduction
- •Advantages of Day Surgery
- •Hernia Repair
- •Pathway
- •First Access in Hospital
- •Social Criteria
- •Medical Criteria
- •Surgical Criteria
- •Preoperative Screening and Selection
- •Day of Surgery
- •Operating Theater
- •Discharge
- •Follow-Up
- •References
- •5: Economics of Hernia Repair
- •Introduction
- •An Introduction to Economics
- •The Cost-Effectiveness of Hernia Repair Surgery
- •Comparison of Open Mesh with Non-mesh Repair
- •Comparison of Laparoscopic with Open Repair
- •Presenting the Uncertainty Surrounding Estimates of Ef fi ciency
- •Summary of Cost-Effectiveness Data
- •Day Case Surgery
- •Type of Anesthesia
- •Choice Between Disposable and Reusable Laparoscopic Equipment
- •The Impact of Surgeon Experience on Cost-Effectiveness
- •Conclusions
- •References
- •References
- •6: Principles in Hernia Surgery
- •General Principles
- •Hemostasis
- •Sepsis
- •Wound Healing
- •Sutures
- •Synthetic Absorbable Sutures
- •Nonabsorbable Sutures
- •Mechanical Factors in Abdominal Wound Closure
- •Knots
- •Suture Manipulation
- •Skin Closure
- •Techniques of Placement of Prosthetic Materials
- •Summary: Recommendations
- •7: Prostheses and Products for Hernioplasty
- •Introduction
- •Indications for Use of Prosthetic Materials
- •Prosthetic Materials: History
- •Absorbable Prosthetic Biomaterials
- •Biologic Products
- •Cadaveric Products
- •Bovine Products
- •Porcine Products
- •Flat Prosthetic Biomaterials
- •Miscellaneous Flat Products
- •Flat Mesh Devices for Inguinal Hernioplasty
- •Combination Flat Synthetic Prosthetics for Hernioplasty
- •Preformed Prosthetic Devices for Open Hernioplasty
- •Extraperitoneal Prosthetic Devices for Open Inguinal Hernioplasty
- •Pre-shaped Products for Laparoscopic Inguinal Hernioplasty
- •Prostheses for Incisional and Ventral Hernioplasty with an Absorbable Component
- •Combination Permanent Materials for Incisional and Ventral Hernioplasty
- •Stomal Hernia Prevention and Repair Products
- •Hiatal Hernia Repair Products
- •Fixation Devices
- •Mesh Delivery Devices
- •Conclusion
- •References
- •8: Biology of Prosthetics
- •History of Mesh
- •Synthetic Mesh Design
- •Adverse Events from Synthetic Mesh
- •Contraction and Migration
- •Mesh Ingrowth and Adhesions
- •Mesh Infection
- •Rare Mesh Complications
- •Biologic Mesh
- •New Model to Evaluate Clinical Outcomes
- •Conclusion
- •References
- •9: Anesthesia
- •Anesthesia for Groin Hernia Surgery
- •Background
- •Anesthetic Techniques
- •Preemptive Analgesia
- •General Anesthesia
- •Techniques
- •Regional Anesthesia
- •Techniques
- •Local Anesthesia
- •History
- •Local Anesthetic Agents
- •Local Anesthetic Techniques
- •Anatomy of the Groin Area
- •Inguinal Block Technique
- •Local In fi ltration Technique
- •Laparoscopic Hernia Repair
- •Complications of Local Anesthetics
- •Local Anesthesia for Other Small Abdominal Wall Hernias
- •Postoperative Outcome of the Anesthetic Techniques
- •Postoperative Pain
- •Early Complications
- •Recovery
- •Recurrence
- •Patient Satisfaction
- •Costs
- •Conclusions
- •References
- •10: Complications of Hernia in General
- •Incarceration, Obstruction, and Strangulation
- •Strangulated External Hernia in General
- •Strangulation in Groin Hernias
- •Strangulation in Ventral Hernias
- •Strangulation in Other Hernias
- •Management of Strangulation
- •Reductio-en-Masse
- •Maydl’s Hernia and Afferent Loop Strangulation
- •Strangulation of the Appendix in a Hernial Sac
- •Richter’s Hernia
- •Littre’s Hernia: Hernia of Meckel’s Diverticulum
- •Hernia of Ovary, Fallopian Tube, and Uterus
- •Urinary Tract Complications
- •Testicular Strangulation
- •Spontaneous and Traumatic Rupture
- •Involvement of Hernial Sac in Disease Process
- •Nodular Mesothelial Hyperplasia and Mesothelioma
- •Carcinoma as a Complication of Hernial Sacs
- •Gynecological Tumors: Endometriosis and Leiomyomas
- •Acute Inflammation: Peritonitis and Appendicitis as Complications of a Hernial Sac
- •References
- •11: Inguinal Hernias in Children
- •History
- •Embryology and Anatomy
- •Embryology
- •Anatomy of the Inguinal Canal in Children
- •Etiology and Clinical Presentation
- •Etiology
- •Clinical Presentation
- •Incidence
- •Clinical Features
- •Examination
- •Differential Diagnosis
- •Investigations
- •Management
- •Treatment in Childhood
- •Postoperative Care
- •Complications
- •Histology
- •Special Issues in Management of Hernias in Children
- •Incarcerated Hernia
- •Incarcerated Ovary
- •Metachronous Hernia
- •Premature Infants
- •Congenital Hydrocele
- •Sliding Hernia
- •Direct Inguinal Hernia
- •Operative Techniques
- •The Open Inguinal Approach (Fig. 11.5)
- •The High Scrotal “Bianchi” Approach
- •Laparoscopic Closure
- •Variations in Laparoscopic Technique
- •Flip-Flap Closure
- •Laparoscopic Inversion Ligation
- •The Reverdin* Needle Technique
- •Laparoscopic Percutaneous Extraperitoneal Closure
- •Percutaneous Internal Ring Suturing
- •Tissue Adhesives
- •Conclusion
- •References
- •12: Umbilical Hernia in Babies and Children
- •Introduction
- •History of Umbilical Hernia Management
- •Umbilical Pathology in Children
- •Formation of the Anterior Abdominal Wall and Its Relation to Umbilical Hernia
- •Physiology/Natural History of the Umbilicus After Birth
- •Natural History of Congenital Umbilical Hernias
- •Epidemiology of Umbilical Hernia
- •Prematurity
- •Racial Variation
- •Incarceration and Strangulation
- •Incidence of Incarceration
- •Predicting Which Umbilical Hernias will Incarcerate
- •Recurrent Incarceration
- •Outcome of Incarcerated Umbilical Hernia
- •Conditions Mimicking Incarcerated Umbilical Hernia
- •Rupture and Evisceration
- •Clinical De fi nition of Congenital Umbilical Hernia
- •Diagnosing Umbilical Hernia
- •Consent and Indications for Surgery
- •Consent
- •Indications for Operating on Umbilical Hernia
- •Incidental Closure
- •Management Options for Umbilical Hernia
- •Observation
- •Diagnostic Work-Up
- •Procedural
- •Preoperative Reduction
- •Anesthesia for Umbilical Hernia
- •Surgical Options for Umbilical Hernia
- •Position and Prepping of the Patient
- •Draping
- •Incision
- •Sac Dissection
- •Minimally Invasive Technique for Umbilical Hernia Repair
- •Recommendations Based on Level of Evidence
- •Expected Posttreatment Course and Postoperative Care
- •Postoperative Complications and Treatment of Complications
- •Bleeding
- •Infection
- •Cosmetic Concerns
- •Recurrence
- •References
- •13: Diagnosis of a Lump in the Groin in the Adult
- •Inguinal Hernia: The Adolescent and the Adult
- •Femoral Hernia
- •Differential Diagnoses of Groin Bulges
- •Hydrocele
- •Vascular Disease
- •Lymphadenopathy
- •Tumors
- •Secondary Tumors
- •Genital Anomalies
- •Obturator Hernia
- •Rarities
- •Clinical Examination of a Swelling in the Groin
- •Inguinoscrotal Pain
- •Groin Disruption in Sportsmen/Athletes
- •Clinical Examination of Patients with Groin Pain
- •Investigations in Occult Hernia and Groin Pain
- •Herniography
- •Ultrasonography
- •Computed Tomography
- •Magnetic Resonance Imaging
- •Laparoscopy
- •Clinical Dilemmas
- •Conclusions
- •References
- •14: Anterior Open Repair of Inguinal Hernia in Adults
- •Classi fi cation of Inguinal Hernia
- •Gilbert Classi fi cation
- •Nyhus Classi fi cation
- •Type I
- •Type II
- •Type III
- •Type IV
- •Zollinger Classi fi cation
- •The EHS Classi fi cation
- •One Fits All or Tailored Repair?
- •Historical Development: Milestones in Open Inguinal Repair
- •Principles of Open Inguinal Hernia Repair
- •Step I: The Preparation
- •The Skin Incision
- •The Dissection of the Canal
- •Identi fi cation of the Fascia Transversalis
- •The Management of the Hernial Sac
- •Indirect
- •No Contents
- •Small Bowel and/or Omentum, With or Without Adhesions
- •Sliding Hernia
- •Direct
- •Combined Direct and Indirect
- •Step II: The Reconstruction
- •Open Suture Technique
- •Marcy/Zimmermann Suture Repair
- •Results and Evaluation
- •Shouldice Repair
- •Dissection of Fascia Transversalis
- •Repair of Fascia Transversalis
- •Reinforcement with the Conjoint Tendon
- •External Oblique Aponeurosis
- •Subcutaneous Tissue and Skin Closure
- •Results and Evaluation
- •McVay: Repair
- •Results and Evaluation
- •The Open Anterior Mesh Repair
- •The Lichtenstein Technique
- •The Lichtenstein Tension-Free Hernioplasty
- •Mesh Fixation
- •Results and Evaluation
- •Antibiotic Prophylaxis
- •Plug-and-Patch Repair
- •Results and Evaluation
- •Recurrent Inguinal Hernia
- •Inguinal Hernia in Women
- •Bilateral Hernia
- •Conclusion
- •References
- •15: Extraperitoneal or Preperitoneal Open Repair of Groin Hernias Using Prosthetic Reinforcement
- •Introduction
- •History
- •The Myopectineal Ori fi ce
- •Indications for the Open Preperitoneal Technique
- •The Operations
- •Advantages of a Preperitoneal Approach
- •Operative Techniques of Open Preperitoneal Repair
- •Preoperative Preparation
- •Choice of Anesthesia
- •Operative Technique: Stoppa and Wantz
- •The Bilateral Stoppa Operation
- •Dealing with the Spermatic Cord: “Parietalization”
- •Insertion of the Mesh
- •The Unilateral Wantz Operation
- •Choice of Prosthesis
- •Operative Technique (Kugel and Ugahary): Open “Minimal Access” Preperitoneal Placement of the Prosthesis
- •The Kugel Repair
- •The Ugahary Operation
- •Personal Comment (MK)
- •Results
- •Conclusion
- •References
- •16: Laparoscopic Inguinal Hernia Repair
- •Introduction
- •Extraperitoneal Operation
- •Anesthesia
- •Position of the Patient on the Table
- •Trocars and Trocar Position
- •Laparoscope
- •Developing the Extraperitoneal Space
- •Dissection
- •Indirect Inguinal Hernias in Males
- •Indirect Inguinal Hernias in Females
- •Direct Inguinal Hernias
- •Femoral Hernias
- •Recurrent Hernias
- •Bilateral Hernias
- •Fixation of the Mesh
- •Conversion to Open Repair
- •Contraindications to Totally Extraperitoneal Hernia Repair
- •Transabdominal Hernia Repair
- •Results
- •Disadvantages of Laparoscopic Hernia Repair
- •Conclusions
- •References
- •17: Femoral Hernia
- •Anatomy
- •Presentation
- •Differential Diagnosis
- •Management of Femoral Hernias
- •Operative Approaches to Femoral Hernia
- •The “Low” or Crural Operation
- •Preoperative Management
- •Anesthesia
- •The Operation
- •Position of Patient
- •Draping
- •The Incision
- •Mobilization of Sac
- •Identi fi cation of Femoral Opening
- •Inspection of Contents of Sac
- •Closure and Excision of Sac
- •Repair of Canal
- •Comment on Crural Operation
- •Inguinal Operation
- •Comment on Inguinal Operation
- •Extraperitoneal (Preperitoneal) Operation
- •Comment on Extraperitoneal Operation
- •The Three Open Approaches
- •Open Prosthetic Repair
- •Plug and Patch
- •Laparoscopic Femoral Hernia Repair
- •Strangulation
- •Unusual Variants of Femoral Hernia
- •Conclusions
- •References
- •18: Umbilical, Epigastric, and Spigelian Hernias
- •Introduction
- •Embryology
- •Anatomy of the Abdominal Wall
- •Spigelian Hernia
- •De fi nition and Epidemiology
- •History
- •Current Literature
- •Epigastric Hernia
- •De fi nition and Epidemiology
- •History
- •Literature
- •Umbilical Hernia
- •De fi nition and Epidemiology
- •History
- •Umbilical Hernia and Cirrhosis
- •Current Literature
- •Presentation and Diagnosis of Anterior Abdominal Wall Hernias
- •Preoperative Planning
- •Treatment of Anterior Abdominal Wall Hernia
- •Laparoscopic Anterior Abdominal Wall Hernia Repair
- •Complications
- •Postoperative Activities
- •References
- •19: Lumbar Hernia
- •Anatomy
- •Clinical Features
- •The Operation
- •Conclusions
- •References
- •20: Hernias of the Pelvic Wall
- •Sciatic Hernia
- •Anatomy
- •Clinical Presentation
- •Treatment
- •Obturator Hernia
- •Anatomy
- •Clinical Presentation
- •Treatment
- •Perineal Hernia
- •Anatomy
- •Presentation
- •Treatment
- •Supravesical Hernia
- •Conclusion
- •References
- •21: Incisional Hernia: The “Open” Techniques (Excluding Parastomal Hernia)
- •Historical Note
- •Symptoms and Signs
- •Incidence
- •Etiologic Factors
- •Principles of Open Repair
- •Incisional Hernia Following Appendectomy
- •Traumatic Abdominal Wall Hernia
- •Pneumoperitoneum as an Aid in Surgical Treatment of Giant Hernias
- •Indications for Operation
- •Contraindications to Elective Operation
- •Choice of Operative Technique
- •Prosthetic Mesh Operation
- •Classi fi cation
- •Anesthesia
- •The Open Operation
- •Position of Patient
- •The Incision
- •Removal of Overlying Redundant Tissue
- •Exposure
- •Managing the Peritoneal Sac
- •Contents of the Sac
- •Closure of Aponeurotic Layer
- •Postoperative Care
- •The Choices of Technique in Open Prosthetic Repair
- •The Onlay (Prefascial, Chevrel) Technique for Open Prosthetic Repair
- •Incision and Dissection
- •The Sublay (Retrorectus, Rives) Repair
- •Open Intraperitoneal Prosthetic Mesh Repair
- •Components Separation Method for Complete Closure of Abdominal Wall Defects
- •Infected Incisional Hernia
- •Chronic Seroma (Pseudocyst of the Abdominal Wall)
- •Results
- •Conclusions
- •References
- •22: Laparoscopic Incisional and Ventral Hernia Repair
- •Introduction
- •Preoperative Evaluation
- •Intraoperative Considerations
- •Patient Preparation and Positioning
- •Abdominal Entry
- •Instruments
- •Prosthetic Biomaterials
- •Adhesiolysis and Identi fi cation of the Fascial Defect(s)
- •Placement of the Prosthesis
- •Immediate Postoperative Considerations
- •Late Postoperative Considerations
- •Hernioplasty of Infrequent Defects
- •Results
- •Obesity and LIVH
- •Conclusion
- •References
- •23: Parastomal Hernia
- •De fi nition of Parastomal Hernia
- •Incidence of Parastomal Hernias
- •Prevention of Parastomal Hernias
- •Principles of Surgical Management of Parastomal Hernias
- •Repairing Parastomal Hernias
- •Mesh Repair of Parastomal Hernias
- •Technique of Subcutaneous Prosthetic Repair
- •Technique of Extraperitoneal Prosthetic Repair
- •The Sugarbaker Technique of Open IPOM Repair
- •Technique of Stoma Relocation
- •Conclusions
- •References
- •24: The Laparoscopic Repair of Parastomal Hernias
- •Introduction
- •Keyhole Technique
- •Sugarbaker Technique
- •Sandwich Technique
- •Discussion
- •Conclusion
- •References
- •25: Complications of Laparoscopic Incisional and Ventral Hernia Repair
- •Introduction
- •Recurrence
- •Risk Factors for Recurrence
- •Morbid Obesity
- •What You Cannot See Can Recur
- •Pseudo-Recurrence
- •Conversion
- •Laparoscopy
- •Seroma
- •Mesh Infection
- •Bowel Injury or Visceral Injury
- •Bowel Adhesions and Mesh Erosion
- •Pain and Quality of Life
- •Readmission, Reoperation, and Mortality
- •Summary
- •References
- •26: Sports Hernias and Athletic Pubalgia
- •Background and Epidemiology
- •Differential Diagnosis
- •Diagnostic Evaluation
- •Clinical Presentation
- •Imaging
- •Pathophysiology
- •Surgical Treatment
- •Surgical Approaches
- •Primary Pelvic Floor Repair
- •Open Tension-Free Mesh Repair
- •Laparoscopic (Posterior) Mesh Repair
- •Laparoscopic Repair
- •Rehabilitation
- •Summary
- •References
- •Index


Management of Abdominal Hernias


Andrew N. Kingsnorth • Karl A. LeBlanc
Editors
Management of Abdominal Hernias
Fourth Edition

Editors
Andrew N. Kingsnorth
Department of Surgery
Peninsula College of Medicine & Dentistry
Plymouth, Devon , UK
Karl A. LeBlanc
Surgeons Group of Baton Rouge/
Our Lady of the Lake Physician Group
Baton Rouge, LA, USA
ISBN 978-1-84882-876-6 ISBN 978-1-84882-877-3 (eBook)
DOI 10.1007/978-1-84882-877-3
Springer London Heidelberg New York Dordrecht
Library of Congress Control Number: 2012953269
© Springer Science+Business Media London 2013
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computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this
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Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the
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The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not
imply, even in the absence of a speci fi c statement, that such names are exempt from the relevant protective laws and
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While the advice and information in this book are believed to be true and accurate at the date of publication, neither
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be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.
Printed on acid-free paper
Springer is part of Springer Science+Business Media (www.springer.com)

Preface
The literature in hernia surgery is vast, and keeping abreast of developments is a never-ending
task that one or two individuals may fi nd dif fi cult to fi t into their daily routine. With this in
mind, for the fourth edition of this book, we have recruited selected experts to write each chapter, so that a ray of discerning knowledge is beamed into each crevice of the hernia story to
create a comprehensive and authoritative text.
A detailed description of the anatomy of the abdominal wall is of utmost importance and a
primary concern for planning all hernia operations. Recent technical developments will
in fl uence our decision making now and in the future. More training is needed to increase
awareness of the large number of prosthetic meshes, innovative plastic procedures, and the
appropriate use of biologic meshes. Each requires a thorough knowledge of the literature and
outcomes research rather than the mere use of a technique or product because it is new and
“seems like a good idea.”
The long-term outcomes of our patients are now an area of important consideration and can
no longer be overlooked in the discussion of consent prior to surgery. This discussion includes
the issue of postoperative pain, quality of life, recurrence rates, and cosmesis.
Hernia science is a relatively new specialty, and its future will be de fi ned by the introduction of “physiologic” repairs and the prosthetic meshes used. Biologic products may be used
for tissue replacement, for tissue reinforcement, or simply as a “bridge” to synthetic materials
that will perform as good as or better than the biologic materials.
This text strives to introduce these concepts and to educate readers about the current state
of the art in hernia surgery and to prepare them for future considerations of which we should
all be aware at this point.
Plymouth , UK A N. Kingsnorth
LA , USA K . LeBlanc
v


Preface to the Third Edition
The fi rst edition of this book was a monograph written by the late H. Brendan Devlin and was
a landmark in the scienti fi c analysis of surgery of the abdominal wall, which discarded many
of the older out-of-date concepts. We are heavily indebted to Brendan not only for providing
the basis for this text but also for the inspiration to follow along a line of inquiry for evidencebased material to present to our readers. At the same time we have not neglected the important
historical and economic aspects of hernia surgery and some of our own personal views. Andrew
Kingsnorth assisted Brendan in writing the second edition of this book, and Karl Le Blanc now
adds an entirely new perspective from North America with particular emphasis on the use of
prosthetic materials and laparoscopic techniques.
We have thoroughly revised and added to all the chapters resulting in an increase in material
of approximately 50% and the addition of hundreds more up-to-date references. We have also
provided the reader with clear line drawings of operative techniques, photographs, and several
short video clips on CD-ROM. This extra effort should allow the reader the ability to adopt and
apply much of the information and operative techniques that are presented. The technological
revolution that began a decade ago and still continues to evolve has therefore been fully recognized in this text which we believe will appeal to surgeons in training and those already experienced in managing abdominal wall hernias. It is hoped that this work will be an effective
reference to all those that possess this book.
vii


Contents
1 General Introduction and History of Hernia Surgery . . . . . . . . . . . . . . . . . . . . . . . . 1
Andrew N. Kingsnorth
2 Essential Anatomy of the Abdominal Wall . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Vishy Mahadevan
3 Epidemiology and Etiology of Primary Groin Hernias . . . . . . . . . . . . . . . . . . . . . . 55
Brian M. Stephenson
4 Logistics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Giampiero Campanelli, Marta Cavalli, Valentina Bertocchi,
and Cristina Sfeclan
5 Economics of Hernia Repair. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Luke Vale
6 Principles in Hernia Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
David H. Bennett
7 Prostheses and Products for Hernioplasty. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Karl A. LeBlanc
8 Biology of Prosthetics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Bruce Ramshaw and Sheila Grant
9 Anesthesia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159
Pär Nordin
10 Complications of Hernia in General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Morten Bay-Nielsen
11 Inguinal Hernias in Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
Aly Shalaby and Joe Curry
12 Umbilical Hernia in Babies and Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
Anjili Khakar and Simon Clarke
13 Diagnosis of a Lump in the Groin in the Adult. . . . . . . . . . . . . . . . . . . . . . . . . . . . 213
Andrew C. de Beaux and Dilip Patel
14 Anterior Open Repair of Inguinal Hernia in Adults . . . . . . . . . . . . . . . . . . . . . . . 227
Joachim Conze
15 Extraperitoneal or Preperitoneal Open Repair of Groin Hernias
Using Prosthetic Reinforcement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
Martin Kurzer
16 Laparoscopic Inguinal Hernia Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 271
Karl A. LeBlanc, Brent W. Allain Jr., and William C. Streetman
ix
Соседние файлы в папке Библиотека им академика М.И. Перельмана
