Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_961_Библиотеки_им_академика_М_И_Перельмана.pdf
402 L.M. Brunt
accelerated path for return to sport in athletes undergoing the
minimal repair technique. Patients are allowed to lift up to
20 kg for the fi rst 14 days after surgery. Biking and running
may be resumed as soon as the athlete is pain free and activity can be increased after the fi rst 8 days as tolerated. This
approach resulted in return to sport activity in 83% of athletes. These fi ndings make the case for a more rapid and
fl exible timeline for increased activity in this population of
patients that is based on symptoms and comfort level rather
than a rigid time-based sequence, especially for athletes who
have surgery in season, in order to minimize the number of
training sessions and games missed.
Summary
In summary, groin injuries are a signi fi cant problem in athletes. A multidisciplinary team approach to evaluation and
management involving the athletic trainer, orthopedist, physical therapist, and general surgeon is key to accurate diagnosis, treatment, and selection of patients for surgical
intervention. Surgeons who evaluate athletes for “athletic
hernia” must develop an understanding of the clinical presentation and diagnostic evaluation of related groin injuries.
Surgical repair, coupled with a structured rehabilitation program that focuses on balancing strength and fl exibility in the
lower abdominal and thigh muscles, should allow return to
competitive play within several weeks in appropriately
selected athletes.
References
1. Renstrom P, Peterson L. Groin injuries in athletes. Br J Sports Med.
1980;14:30–6.
2. Ekstrand J, Hilding J. The incidence and differential diagnosis of
acute groin injuries in male soccer players. Scand J Med Sci Sports.
1999;9:98–103.
3. Smodlaka VN. Groin pain in soccer players. Phys Sportsmed.
1980;8:57–61.
4. Pettersson R, Lorenzton R. Ice hockey injuries: a 4 year prosepctive
study of a Swedish elite ice hockey team. Br J Sports Med.
1993;27:251–4.
5. Stuart MJ, Smith A. Injuries in Junior A ice hockey: a 3 year prospective study. Am J Sports Med. 1995;23:458–61.
6. Lorentzen R, Wedren H, Pietila T. Incidences, nature, and causes of
ice hockey injuries: a three year prospective study of a Swedish
elite ice hockey team. Am J Sports Med. 1988;16:392–6.
7. Molsa J, Airaksinen O, Nasman O, et al. Ice hockey injuries in
Finland: a prospective epidemiologic study. Clin J Sport Med.
1997;9:151–6.
8. Emery CA, Meeuwisse WH, Powell J. Groin and abdominal injuries in the National Hockey League. Clin J Sport Med.
1999;9:151–6.
9. Emery CA, Meeuwisse WH. Risk factors for groin injuries in
hockey. Med Sci Sports Exerc. 2001;33:1423–33.
10. Tyler TF, Nicholas SJ, Campbell RJ, McHugh MP. The association
of hip strength and fl exibility with the incidence of adductor muscle
strains in professional ice hockey players. Am J Sports Med.
2001;29:124–8.
11. Lacroix VJ. A complete approach to groin pain. Phys Sportsmed.
2000;28:66–86.
12. Anderson K, Strickland AM, Warren R. Hip and groin injuries in
athletes. Am J Sports Med. 2001;29:521–33.
13. Swan KGJ, Wolcott M. The athletic hernia. Clin Orthop Relat Res.
2006;455:78–87.
14. Nam A, Brody F. Management and therapy for sports hernia. J Am
Coll Surg. 2008;206:154–64.
15. Caudill P, Nyland J, Smith C, Yerasimides J, Lach J. Sports hernias:
a systematic literature review. Br J Sports Med.
2008;42(12):954–64.
16. Fricker PA, Taunton JE, Ammann W. Osteitis pubis in athletes:
infection, in fl ammation, or injury. Sports Med. 1991;12:266–79.
17. Schlegel TF, Bushnell BD, Godfrey J, Boublik M. Success of nonoperative management of adductor longus tendon ruptures in
National Football League athletes. Am J Sports Med.
2009;37:1394–9.
18. Ekstrand J, Ringbog S. Surgery versus conservative treatment in
soccer players with chronic groin pain: a prospective, randomized
study in soccer players. Eur J Sports Traumatol Relat Res.
2001;23:141–5.
19. Meyers W, Foley D, Garrett W, Lohnes J, Mandelbaum B.
Management of severe lower abdominal or inguinal pain in highperformance athletes. Am J Sports Med. 2000;28:2–8.
20. Hemingway AE, Herrington L, Blower AL. Changes in muscle
strength and pain in response to surgical repair of posterior abdominal wall disruption followed by rehabilitation. Br J Sports Med.
2003;37:54–8.
21. Steele P, Annear P, Grove JR. Surgery for posterior inguinal wall
de fi ciency in athletes. J Sci Med Sport. 2004;7:415–21.
22. Gilmore OJA. Gilmore’s groin: ten years experience of groin disruption—a previously unsolved problem in sportsmen. Sports Med
Soft Tissue Trauma. 1991;3:12–4.
23. Gilmore OJA. Gilmore’s groin. Sports Med Soft Tissue Trauma.
1992;3:3.
24. Irshad K, Feldman L, Lavoie C, Lacroix V, Mulder D, Brown R.
Operative management of “hockey groin syndrome”: 12 years
experience in National Hockey League players. Surgery.
2001;130:759–66.
25. Meyers WC, McKechnie A, Philippon MJ, Horner MA, Zoga AC,
Devon ON. Experience with “sports hernia” spanning two decades.
Ann Surg. 2008;248:656–65.
26. Brunt LM, Quasebarth MA, Bradshaw J, Barile R. Outcomes of a
standardized approach to surgical repair and postoperative rehabilitation of athletic hernia. AOSSM Annual Meeting 2007: Calgary.
27. Zoga AC, Kavanagh EC, Meyers WC, et al. MRI fi ndings in athletic
pubalgia and the “sports hernia”. Radiology. 2008;247:797–807.
28. Omar IM, Zoga A, Kavanagh EC, et al. Athletic pubalgia and
“sports hernia”: optimal MR imaging technique and fi ndings.
Radiographics. 2008;28:1415–38.
29. Orchard JW, Read JW, Neophyton J, Garlick D. Groin pain associated with ultrasound fi nding of inguinal canal posterior wall
de fi ciency in Australian Rules footballers. Br J Sports Med.
1998;32:134–9.
30. Muschawek U, Berger L. Minimal repair technique of sportsmen’s
groin: an innovative open-suture repair to treat chronic groin pain.
Hernia. 2010;14:27–33.
31. Meyers WC, Greenleaf R, Saad A. Anatomic basis for evaluation of
abdominal and groin pain in athletes. Oper Tech Sports Med.
2005;13:55–61.
32. Meyers WC, Yoo E, Devon ON, et al. Understanding “sports hernia” (athletic pubalgia): The anatomic and pathophysiologic basis
for abdominal and groin pain in athletes. Oper Tech Sports Med.
2007;15:165–77.
40326 Sports Hernias and Athletic Pubalgia
33. Biedert RM, Warnke K, Meyer S. Symphysis syndrome in athletes:
surgical treatment for chronic lower abdominal, groin, and adductor
pain in athletes. Clin J Sport Med. 2003;13:278–84.
34. Farber AJ, Wilckens JH. Sports hernia: diagnosis and therapeutic
approach. J Am Acad Orthop Surg. 2007;15:507–14.
35. Muschawek U, Berger LM. Sportsmen’s groin—diagnostic
approach and treatment with the minimal repair technique. Sports
Health. 2010;2:216–21.
36. Brown R, Mascia A, Kinnear DG, Lacroix VJ, Feldman L, Mulder
DS. An 18 year review of sports groin injuries in the elite hockey
player: clinical presentation, new diagnostic imaging, treatment,
and results. Clin J Sport Med. 2008;2008:221–6.
37. Paajanen H, Syvahuoko I, Airo I. Totally extreparitoneal endoscopic (TEP) treatment of sportsman’s hernia. Surg Laparosc
Endosc Percutan Tech. 2004;14:215–8.
38. van Veen RN, de Baat P, Heijboer MP, et al. Successful endoscopic
treatment of chronic groin pain in athletes. Surg Endosc.
2007;21:189–93.
39. Ziprin P, Prabhudesai SG, Abrahams S, Chadwick SJ. Transabdominal
preperitoneal laparoscopic approach for the treatment of sportsman’s hernia. J Laparoendosc Adv Surg Tech A. 2008;18:669–72.
40. Ingoldby C. Laparoscopic and conventional repair of groin disruption in sportsmen. Br J Surg. 1997;84:213–5.
41. Polglase AL, Frydman GM, Farmer KC. Inguinal surgery for debilitating chronic groin pain in athletes. Med J Aust. 1991;155:674–7.
42. Joesting DR. Diagnosis and treatment of sportsman’s hernia. Curr
Sports Med Rep. 2002;1:121–4.
43. Evans DS. Laparoscopic transabdominal pre-peritoneal (TAPP)
repair for groin hernia: one surgeon’s experience of a developing
technique. Ann R Coll Surg Engl. 2002;84:393–8.
Index
A
Abdominal wall
comparative anatomy , 50–51
conjoint tendon
falx inguinalis , 41
internal oblique and transversus muscle , 42
shutter mechanism , 40
defects , 99
external anatomy , 25–26
external oblique muscle
apex of cleft , 34
aponeurosis , 33
inferior (deep) epigastric vessels , 34
inguinal ligament , 34, 35, 38, 39
lacunar ligament , 34
natural defect , 33
posterior border , 33
super fi cial inguinal ring , 33–36
fascia transversalis
anatomy , 47
direct hernia , 47
extraperitoneal fat , 45, 46
femoral vessels , 48
groin region , 45
iliopubic tract , 46–47
inguinal ligament , 46
inguinofemoral hernia , 48
lower abdomen and pelvis , 44
space of Bogros , 49
upper abdominal wall , 45
U-shaped sling , 44, 46
functions , 45
internal oblique muscle
fl eshy muscle , 36
lamellae , 36, 40
lowest fi bers , 36, 39
muscular bands , 36
origin and insertion , 36, 40
rarely fi bers , 38, 41
spermatic cord , 36
spigelian hernia , 38, 41
linea alba , 43–45
muscle innervation and blood supply , 44–45
musculoaponeurotic plane , 32
peritoneum , 49, 50
principles , 91
radiological anatomy , 51–52
rectus abdominis muscle , 32–33
rectus sheath , 43–45
skin , 26
spermatic cord , 50–51
super fi cial nerves
anterior scrotum , 30
femoral sheath , 30
genitofemoral nerve , 29–30
iliohypogastric and ilioinguinal nerves , 29, 30
intercostal nerve , 29
somatic nerve , 31
thigh, lateral cutaneous nerve , 30, 31
“triangle of pain and doom,” , 31
transverse abdominal muscle , 39–40, 42
umbilicus , 49–50
AbsorbaTack , 145, 146
Adhesiolyis , 360, 363
Adrenaline , 162
Adults
anterior open repair of inguinal hernia ( see Anterior open repair)
femoral hernias , 59–60
groin lump, diagnosis of ( see Groin lump)
inguinal hernia , 58–59
Amid Hernia Stapler , 146, 147
Anesthesia
femoral hernia , 291
laparoscopic inguinal hernia repair , 273–274
types of , 86–87
Anterior abdominal wall hernia
anatomy
linea alba , 302
rectus abdominis , 301, 303
spigelian hernia belt , 302, 304
transversus , 301, 303
complications , 309
diagnosis of , 307
embryology , 301, 302
epigastric hernia , 304–305
laparoscopic repair , 309
postoperative activities , 310
preoperative planning , 308
spigelian hernia , 302–304
treatment , 308–309
umbilical hernia , 305–307
Anterior open repair
antibiotic prophylaxis , 249
bilateral open procedure , 251–252
canal dissection , 234, 235
fascia transversalis , 234–235
A.N. Kingsnorth and K.A. LeBlanc (eds.), Management of Abdominal Hernias,
DOI 10.1007/978-1-84882-877-3, © Springer Science+Business Media London 2013
405
406 Index
Anterior open repair (cont.)
hernial sac
combined direct and indirect “pantaloon” sac ,
237–238
direct hernial sac , 237
indirect hernial sac , 236
reconstruction , 238
sliding hernia , 236–237
strangulated omentum/small bowel , 236
historical development , 232–233
Marcy/Zimmermann suture repair , 238
McVay repair , 243–245
Mesh repair, Lichtenstein technique
evaluation and outcome , 248–249
fi xation , 248
nonabsorbable mesh , 245
suture , 245–247
open suture technique , 232, 238
plug-and-patch repair , 249–251
principles , 234
Shouldice repair
conjoint tendon , 241–242
evaluation and outcome , 242–243
external oblique aponeurosis , 242
fascia transversalis , 239–241
subcutaneous tissue and skin closure , 242
skin incision , 234
Appendectomy
incisional hernia , 331
inguinal hernia and , 66–67
Appendicitis , 176, 182
B
Benzodiazepines , 160
Bilateral hernias
inguinal hernia , 251–252
laparoscopic repair , 278
Bilateral stoppa procedure , 260–262
Bupivacaine , 162
C
Cadaveric biologic prostheses
AlloDerm , 107
AlloMax , 108
DermaMatrix , 107
FlexHD , 108
CAIS. See Complete androgen insensitivity syndrome (CAIS)
Calcitonin gene-related peptide (CGRP) , 186
Canadian repair. See Shouldice repair
CAPD. See Continuous ambulatory peritoneal dialysis
(CAPD)
Center for Devices and Radiological Health (CDRH) , 155
Cirrhosis , 306–307
Cocaine , 161
Complete androgen insensitivity syndrome (CAIS) , 188
Continuous ambulatory peritoneal dialysis (CAPD) , 176
Cost-effectiveness acceptability curves (CEAC) , 84
C-Qur mesh , 156
Creutzfeld-Jacobs disease , 104
Crural operation
anesthesia , 291
disadvantages of , 292–293
preoperative management , 291
CruraSoft Patch , 144, 145
Cystic hygroma , 218
D
Day surgery , 73–74
Diastasis recti , 104
Direct hernial sac , 237
Direct inguinal hernias
Hesselbach’s triangle , 47
laparoscopic repair , 278
spigelian hernia defects , 38
DualMesh® , 153
E
ECM. See Extracellular matrix (ECM)
Economics and economic evaluation
anesthesia, types of , 86–87
cost-effectiveness
cost-effectiveness acceptability curves , 84
decision analytic modeling , 84
laparoscopic vs. open repair , 83–84
open mesh repair vs. non-mesh repair , 82–83
statistical methods , 84
day case surgery , 86
discrete choice experiment , 81
disposable and reusable laparoscopic equipment ,
87–88
EQ-5D questionnaire , 81
health-care decision-making , 80
health-care system , 80
opportunity cost , 80
quality adjusted life years , 80–81
surgeon experience , 88
willingness to pay , 81
Ehlers–Danlos syndrome , 64
Elective herniorrhaphy , 172
Endometriosis , 182
Endo Universal Stapler , 146, 147
Epigastric hernia
de fi nition and epidemiology , 304–305
history , 305
repair , 305
European Hernia Society , 173
expanded polytetra fl uoroethylene (ePTFE)
DualMesh , 117–119
DualMesh PLUS , 119
DualMesh PLUS with Holes , 119
Dulex , 119
MycroMesh , 119, 120
Mycromesh PLUS , 119, 120
Soft Tissue Patch , 119, 120
External oblique muscle
apex of cleft , 34
aponeurosis , 33
inferior (deep) epigastric vessels , 34
inguinal ligament , 34, 35, 38, 39
lacunar ligament , 34
natural defect , 33
posterior border , 33
super fi cial inguinal ring , 33–36
Extracellular matrix (ECM) , 119
Extraperitoneal prosthetic repair , 373, 374
F
Fascia transversalis
anatomy , 47
anterior open repair
dissection of , 239
407Index
identi fi cation of , 234–235
repair of , 239–240
direct hernia , 47
extraperitoneal fat , 45, 46
femoral vessels , 48
groin region , 45
iliopubic tract , 46–47
inguinal ligament , 46
inguinofemoral hernia , 48
lower abdomen and pelvis , 44
space of Bogros , 49
upper abdominal wall , 45
U-shaped sling , 44, 46
Femoral hernia
anatomy
femoral canal , 287–288
femoral vein and saphenous vein , 288–289
hip joint fl exion , 288, 289
differential diagnosis , 289
emergency presentation , 289
etiology of , 287
fascia transversalis , 290
groin hernia , 290
groin lump , 216–217
hernia surgery ( see Hernia surgery)
hernioplasty , 290
laparoscopic repair , 278, 296–297
management of , 289–290
open approaches , 296
open prosthetic repair , 296
plug and patch , 296
strangulation
Cardiff series , 297–298
emergency and elective groups , 298
laparoscopy , 297
sac sample , 297
terracotta , 1, 2
variants , 298–299
in women , 2, 5
G
Genital anomalies , 217
Genitofemoral nerve , 163
Giant hernias , 331–332
Groin hernia surgery
anatomy , 163
anesthetic techniques , 159
chronic post-herniorrhaphy pain , 159
epidemiology , 55–56
etiology of , 60–62
extraperitoneal/preperitoneal open repair, prosthetic reinforcement
( see Open preperitoneal mesh repair)
femoral hernias , 59–60
general anesthesia , 160
inguinal block technique , 163–164
inguinal hernia ( see Inguinal hernias)
intra-abdominal diseases , 65–66
laparoscopic hernia repair , 165
local anesthesia
agents , 162
complications of , 165
history , 161–162
small abdominal wall hernias , 166
techniques , 162–163
local in fi ltration technique , 164–165
in males and females , 58
postoperative outcomes
costs , 168
early complications , 167
patient satisfaction , 168
postoperative pain , 166–167
recovery , 167
recurrence , 167–168
preemptive analgesia , 159–160
regional anesthesia , 160–161
trauma and pelvic fracture , 67–69
Groin lump
clinical examination , 218–219
cystic hygroma , 218
femoral hernia , 216–217
genital anomalies , 217
hydrocele , 217
inguinal hernia , 215–216
inguinoscrotal pain , 219
lymphadenopathy , 217
obturator hernia , 217–218
pain ( see Groin pain)
psoas abscess , 218
sportsmen/athletes , 219–221
tumors , 217
vascular disease , 217
Groin pain
clinical examination , 221
occult hernia
computed tomography , 224–225
herniography , 222–223
laparoscopy , 225–226
magnetic resonance imaging , 225
ultrasonography , 223–224
H
Hepatocyte growth factor (HGF) , 186
Hernia complications
hernial sac involvement, disease process
acute in fl ammation , 182
carcinoma , 181
gynecological tumors , 182
nodular mesothelial hyperplasia and mesothelioma ,
180–181
incarceration , 171
Littre’s hernia , 177
Maydl’s hernia and afferent loop strangulation , 175–176
ovary, fallopian tube and uterus , 177–178
Richter’s hernia , 176–177
spontaneous and traumatic rupture , 179–180
strangulation
appendix, hernial sac , 176
external hernia , 171–172
groin hernias , 172–173
management of , 173–174
obturator hernias , 173
reductio-en-masse , 174–175
ventral hernias , 173
testicular strangulation , 179
urinary tract complications , 178–179
Hernial sac
combined direct and indirect “pantaloon” sac , 237–238
direct hernial sac , 237
indirect hernial sac , 236
reconstruction , 238
sliding hernia , 236–237
strangulated omentum/small bowel , 236
408 Index
Hernia repair
economics ( see Economics and economic evaluation)
logistics , 74
Hernia surgery
anatomical era
Antonio Scarpa , 3, 6
Camper’s fascia , 3
John Hunter , 6
Sir Astley Paston Cooper , 4, 6
Sir Percival Pott , 3, 6
triangle, in laparoscopic surgery , 7, 8
ancient and renaissance
Chirurgia, Guy de Chauliac , 1, 3
direct and indirect inguinal hernia , 3, 5
Egyptian Tomb, Ankhmahor , 2
frontispiece and surgery instruments, in Traités des Hernies , 2, 4
Phoenician terracotta , 1, 2
preternatural colon fi stula , 3, 5
terracotta , 1, 2
anesthesia , 7
canal repair , 292–293
chronology of , 19–20
crural operation
anesthesia , 291
disadvantages of , 292–293
preoperative management , 291
deep sepsis , 92
draping , 291
extraperitoneal operation , 295
extraperitoneal–preperitoneal approach, groin , 13–14
femoral opening , 291–292
Fruchaud ‘s concepts , 14
Georgian period, in England , 14–15
hemostasis , 92
inguinal operation , 294–295
laparoscopic repair , 16–18
Lichtenstein’s tension-free hernioplasty , 14
Lytle’s anatomy and shutter mechanism, deep inguinal ring , 14
patient position , 291
sac
closure and excision , 292
mobilization , 291
skin incision , 291
sutures
abdominal wound closure , 96–97
knots , 98
manipulation , 98
natural and synthetic suture material , 94, 95
nonabsorbable sutures , 96
principles , 94
skin closure , 98–100
synthetic absorbable sutures , 95–96
technological era
Earl Shouldice’s repair techniques , 12
Edoardo Bassini’s inguinal hernioplasty , 8, 10–11
Halstedian principles , 11
Henry Orville Marcy , 8, 9
MacEwen , 8, 9
Wyllys Andrews ‘s techniques , 11–12
tension-free hernia repair , 16
Winston Churchill’s hernia repair , 15–16
wound healing , 92–94
Hernioplasty
absorbable prosthetic biomaterials
Bio-A , 105
biologic products , 106–107
bovine products , 107–108
cadaveric products , 107
fl at prosthetic biomaterials , 110–119
inguinal hernioplasty, fl at mesh devices , 121–123
miscellaneous fl at products , 119–121
porcine products , 109–110
Sa fi l Mesh , 106
TephaFLEX , 106
TIGR Matrix Surgical Mesh , 106
Vicryl and Dexon meshes , 106, 107
combination fl at synthetic prosthetics
Adhesix , 123
Easy Prosthesis II , 123, 124
Parietene ProGrip , 123, 124
Parietex ProGrip , 123, 124
Ultrapro , 123, 125
Vypro , 123, 125
Vypro II , 123, 125
incisional and ventral hernioplasty
CA.B.S. ‘Air , 138, 139
ClearMesh Composite , 138, 140
Combi Mesh , 139
Composix E/X Mesh , 139, 140
Composix Kugel (CK) Patch , 139, 140
Composix L/P , 140
DynaMesh IPOM , 140
fi xation devices , 145–146
hiatal hernia repair products , 144–145
IntraMesh PROT1 , 141
IntraMesh T1 , 141
IntraMesh W3 , 141
mesh delivery devices , 146–147
MotifMESH , 141
Omyra Mesh , 141
Relimesh , 141, 142
stomal hernia prevention and repair products , 142–144
SurgiMesh XB , 141, 142
TiMesh , 142
Ventralex , 142
Ventrio Hernia Patch , 142
preformed prosthetic devices
extraperitoneal prosthetic devices , 126–128
incisional and ventral hernioplasty , 132–137
laparoscopic inguinal hernioplasty , 128–132
prosthetic materials
history , 104–105
indications , 103–104
HGF. See Hepatocyte growth factor (HGF)
Hurler’s syndrome , 206
Hydrocele , 217
I
Iliohypogastric nerve , 163
Ilioinguinal nerve , 163
Incisional and ventral hernioplasty
Adhesix , 133
Biomerix Composite Surgical Mesh , 133
CA.B.S.’ Air SR , 133, 136
C-QUR , 133, 136
C-QUR EDGE , 133, 137
C-QUR Lite , 133, 137
C-QUR V-Patch , 133, 137
Easy Prosthesis (PPM/Collagen) , 134, 137
Parietene ProGrip and Parietex ProGrip , 135
Parietex Composite , 134, 138
Parietex Composite Skirted Mesh , 134, 138
PHYSIOMESH , 135, 138
409Index
Proceed Mesh , 136, 138
Proceed Ventral Patch , 136, 138
SepraMesh , 136, 139
Ventralex , 137, 142
Ventrio , 137, 142
Incisional hernia
abdominal wall defects , 341–342
appendectomy , 331
chronic seroma , 342
classi fi cation , 334
dissection , 339
etiological factor
in children , 330
lower midline incisions , 329
obesity , 329
wound drain , 329
giant hernias , 331–332
incidence , 328–329
infection treatment , 342
open intraperitoneal prosthetic mesh repair , 340
open prosthetic repair
abdominal wall reconstruction techniques , 338
prefascial and chevrel technique , 338–339
principles of , 330–331
pneumoperitoneum , 331–332
postoperative care , 337
pseudocyst of , 342
spontaneous rupture , 327, 328
sublay repair , 339–341
surgeon-dependent variable , 327
surgery
anesthesia , 334
aponeurotic layer , 337
circumferential exposure , 335–336
contents of sac , 336–337
contraindications , 332–333
elliptical incision , 334
indications , 332
operative technique , 333
patient position , 334
peritoneal sac , 336
prosthetic mesh operation , 333–334
redundant tissue removal , 334–335
symptoms and signs , 327–328
traumatic abdominal wall hernia , 331
Indirect inguinal hernias
in female , 277
hernial sac , 236
in male , 276–277
sac and cord dissection , 3, 5
INFINIT mesh , 119, 120
Inguinal hernias
in adults , 58–59
age-speci fi c hernia , 56, 57
age-standardized hernia surgery rates , 57–58
anatomy , 186
anterior open repair ( see Anterior open repair)
appendectomy , 66–67
childhood treatment , 189–190
classi fi cation
EHS classi fi cation , 231
Gilbert classi fi cation , 230
Nyhus classi fi cation , 230
type I hernias , 230
type II hernias , 231
type III hernias , 231
type IV hernias , 231
Zollinger hernias , 231
clinical features , 188
complications , 190–191
congenital hydrocele , 193
demographic structure , 57
differential diagnosis , 188–189
direct inguinal hernia , 193
Egyptian Tomb, Ankhmahor , 2
Ehlers-Danlos syndrome , 64
embryology , 185–186
etiology , 187–188
examination , 188
fl ip- fl ap closure , 195
genetic factors , 65
Georgian period, in England , 14–15
groin lump , 215–216
high scrotal “Bianchi” approach , 194
histology , 191
history , 185
incarcerated hernia, children , 191–192
incarcerated ovary , 192
incidence , 188
innominate osteotomy , 68
investigations , 189
laparoscopic closure , 194–195
laparoscopic inversion ligation , 195–196
LPEC , 196–197
metachronous hernia , 192
microscopic fi ndings
collagen , 62–63
connective tissue disorder , 64
elastolytic enzyme system , 63
metastatic emphysema , 63–64
MMP-2 overexpression , 63
prevalence of , 63
prosthetic repair , 62
surgical wound healing , 62
transversus abdominis biopsies , 63
open inguinal approach , 193–194
“pantaloon” hernia , 67
pediatric surgical practice , 64–65
percutaneous internal ring suturing , 197
postoperative care , 190
premature infants , 192–193
recurrent , 251
Reverdin needle technique , 196
sliding hernia , 193
subcutaneously endoscopically assisted ligation , 197–198
surgical rates , 56
tissue adhesives , 198
in women , 251
Inguinal hernioplasty, fl at mesh devices
Bard Mesh , 111, 112
Bard Soft Mesh , 111, 112
EaseGrip , 122
Easy Prosthesis , 111, 113
Folded mesh , 122
HydroCoat Mesh , 111
MycroMesh , 119, 120
Optilene Mesh , 113, 114
P3 , 122
P3 Evolution , 122
Surgimesh PET , 122
SurgiMesh WN , 115, 116
TiPATCH , 123
Inguinoscrotal pain , 219
Insulin-like hormone gene (INSL3) , 186
410 Index
Intercostal nerves , 166
Internal oblique muscle
fl eshy muscle , 36
lamellae , 36, 40
lowest fi bers , 36, 39
muscular bands , 36
origin and insertion , 36, 40
rarely fi bers , 38, 41
spermatic cord , 36
spigelian hernia , 38, 41
Intra-abdominal diseases , 65–66
Intravenous midazolam , 163
K
kangaroo tendon , 151
Keyhole technique , 379
Kugel repair , 265, 267–268
L
Laparoscopic incisional ventral hernia (LIVH) repair
abdominal entry , 349–350
adhesiolyis , 360, 363
comparitive analysis , 361
complications
bowel adhesions and mesh erosion , 388–389
bulging and pain , 386
conversion rate data , 386
erythema , 358
fascial defects , 385
laparoscopy , 386–387
large incisional hernia , 358
mesh infection , 387–388
morbid obesity , 385
mortality , 390
pain and quality of life , 389
postoperative , 360, 362
readmission and reoperation , 389
recurrence , 383–384
risk factors , 384–385
seroma , 387
Swiss-cheese defects , 386
trocar site hernias , 386
visceral injury , 388
fascial defects
dissected incisional hernia , 351–352
DualMesh Plus , 352, 353
mesh , 353–354
skin marks , 352
hernioplasty , 358–359
instrumentation , 350–351
laparoscopic fi xation device , 359, 360
obesity , 363
patient preparation and position , 348–349
polypropylene and polyester biomaterials , 351
postoperative considerations , 357–358
preoperative evaluation
contraindications , 348
fascial defect , 347–348
intra-abdominal surgery , 348
trocar , 348
primary suture repair , 347
prosthesis placement
double-crown technique , 356
fastener , 357
hand-off of suture , 356
material fi xation , 354
suture-passing devices , 355–356
transfascial sutures , 355, 357
Laparoscopic inguinal hernia repair
anesthesia , 273–274
bilateral hernias , 278
complications , 280
direct inguinal hernias , 278
disadvantages of , 282–283
dissection , 276
ef fi ciency of , 280
extraperitoneal
contraindication , 279
space development , 275
femoral hernias , 278
indirect inguinal hernias
in female , 277
in male , 276–277
inguinal herniorraphy , 280–281
laparoscope , 275
mesh
fi xation , 279
intraperitoneal placement , 273
open preperitoneal repair , 279
patient position , 274
prosthetic material , 273
recurrent hernias , 278
TAPP vs. TEP , 282
transabdominal hernia repair , 279–280
trocar position , 274
Laparoscopic inguinal hernioplasty
C-LAP , 129, 134
3D Max Light , 131, 135
Folding Mesh with Suture , 129, 135
Parietex Anatomical Mesh , 129, 134
Rebound HRD , 130, 135
SurgiMesh PET , 131, 135
SurgiMesh WN , 116, 131
SurgiMesh XD , 131, 135
Visilex , 132, 136
Laparoscopic inversion ligation (LIL) , 195–196
Laparoscopic percutaneous extraperitoneal closure (LPEC) , 196–197
Lateral inguinal fossa , 185
Leiomyomas , 182
Levobupivacaine , 162
Lignocaine , 162
LIL. See Laparoscopic inversion ligation (LIL)
Linea alba , 43–45
LIVH repair. See Laparoscopic incisional ventral hernia (LIVH) repair
Logistics
day surgery , 73–75
fi rst examination , 74
hernia repair , 74
medical criteria , 74
operating theater , 75
patient discharge , 75–76
periodic follow-up , 76
preoperative screening and selection , 75
social criteria , 74
surgical criteria , 74–75
LPEC. See Laparoscopic percutaneous extraperitoneal closure (LPEC)
Lumbar hernia
abdominal surgery
denervation injury , 313–314
laparoscopic approach , 313
411Index
mesh , 313–314
patient position , 313
anatomy
herniation , 311
intercostal nerve , 311
lumbar region dissection , 311, 312
clinical presentation
abdominal wall deformities , 312
congenital hernias , 311
denervation hernia , 312
traumatic , 313
Lymphadenopathy , 217
M
Maydl’s hernia , 175–176
MCIH. See Metachronous contralateral inguinal hernia (MCIH)
McVay repair , 243–245
Meckel’s diverticulum , 177, 178
Medical device reports (MDRs) , 155
Mesenteric anatomy , 172
Mesh GPS device , 147
Metachronous contralateral inguinal hernia (MCIH) , 192
MotifMesh , 119, 121
MotifMESH Tissue Engineering Biomaterial , 121
MultiFire Hernia Stapler , 146, 147
MultiFire VersaTack Stapler , 146, 148
Muschawek minimal repair technique , 400
Myopectineal ori fi ce (MPO) , 258, 259
O
Obturator hernia
anatomy , 319–320
canal pilot tag , 319, 321
clinical presentation
characteristic of , 320
Howship-Romberg sign , 321
signs or symptoms , 320
groin bulges , 217–218
treatment , 320–322
Occult hernia
computed tomography , 224–225
herniography , 222–223
laparoscopy , 225–226
magnetic resonance imaging , 225
ultrasonography , 223–224
Omega-3 Fatty Acid (O3FA) , 133
Omyra , 121
Open hernioplasty, plug type products
Basic plug , 126
4D Dome , 124, 127
Easy Prosthesis Plug , 124, 127
Parietex Plug , 124
Per fi x Light Plug , 124, 128
PerFix Plug , 124, 128
Premilene Mesh Plug , 125, 129
Proloop Plug , 125, 129
Repol Plug Cap , 125, 129
Repol Plug Flower , 125, 129
Self-Forming Plug , 124, 126
SurgiMesh EasyPlug Standard , 124, 127
SurgiMesh WN EasyPlug , 126, 130
SurgiMesh WN EasyPlug “No Touch,” , 126, 130
T2 and T3 Plugs , 126, 130
TEC Evolution plug , 126, 130, 131
TiLENE plug , 126, 131
TiPLUG , 126, 131
Ultrapro Plug , 126, 131
Open inguinal hernioplasty
Easy Prosthesis preperitoneal hernia repair patch ,
127, 132
Easy Prosthesis self-forming hernia repair patch ,
127, 132
Kugel patch , 127, 132
Modi fi ed Kugel patch , 127, 132
Polysoft Patch , 127, 133
Prolene 3D Patch , 128, 134
prolene hernia system , 127, 133
Ultrapro Hernia System , 127, 133
Open intraperitoneal onlay mesh (IPOM) repair , 373, 375
Open preperitoneal mesh repair
advantages , 260
history of , 257–258
indications , 258, 260
myopectineal ori fi ce , 258, 259
operations , 260
operative techniques
bilateral Stoppa operation , 260–262
general anesthesia , 260
Kugel repair , 265, 267–268
mesh insertion , 260, 263–264
preoperative preparation , 260
prosthesis , 262–263
spermatic cord , 261, 262
Ugahary operation , 265, 268–269
unilateral Wantz operation , 261–262, 264–267
Open tension-free mesh repair , 400–401
Oxidized regenerated cellulose (ORC) , 136
P
Panniculectomy , 338
Parastomal hernias
classi fi cation , 365–367
clinical examination , 365
de fi nition of , 365–366
development , 365
incidence of
extraperitoneal construction , 366
herniation rate , 366
risk factors , 367
laparoscopic repair
complication , 381–382
keyhole technique , 379
sandwich technique , 380–381
Sugarbaker technique , 379–380
occurence , 365
ostomy , 366
prevention of
incisional hernia , 368
laparoscopic dissection , 369
prophylactic mesh , 367–370
stoma formation , 368, 369
repair
extraperitoneal prosthetic , 373, 374
low-weight large-pore mesh , 374, 375
mesh , 371–372
musculo-aponeurotic , 370
open IPOM , 373, 375
stoma relocation , 370–371, 373–374
subcutaneous parastomal hernia , 372
412 Index
Parastomal hernias (cont.)
surgical management
contraindications , 370
diagnosis and assessmentof , 370
Paravertebral block (PVB) , 160
Parietex Anatomical Mesh , 129, 134
Parietex Composite Hiatal Mesh , 145
PatchAssist , 147, 150
Patent processus vaginalis (PPV) , 185
Pelvic wall
chronic pelvic pain , 317
obturator hernia , 319–321
perineal hernia , 321–322
sciatic hernia , 317–319
supravesical hernia , 322–323
Perineal herniography , 322, 323
Peritoneum , 49, 50
Peritonitis , 182
Permacol , 109
PermaFix and SorbaFix , 146, 148
PermaSorb , 146, 148
Pneumoperitoneum , 331–332
Polyester biomaterials
Angimesh R2 , 118
Mersilene , 116, 118
Parietex Flat Sheet Mesh , 116, 118
Parietex Lightweight , 116, 118
Polyethylene terephthalate (PET) , 152–153
Poly-4-hydroxybutyrate (P4HB) , 106
Polylactic acid (PLA) , 106
Polymer polydioxanone (PDO) , 123
Polypropylene products
Bard Mesh , 111, 112
Basic mesh , 111
Biomesh P1, P3, and P9 , 111, 112
Combi Mesh Pro , 111, 113
DynaMesh , 111, 113
Easy Prosthesis Lightweight , 111, 113
Hermesh , 3–8, 111, 113
HydroCoat Mesh , 111
Lapartex , 113, 114
Optilene , 113, 114
Premilene , 113, 114
Prolene , 113, 114
Prolene Soft Mesh , 115
Prolite , 113, 115
Prolite Ultra , 115
Repol Angimesh 0, 1, 8, and 9 , 115, 116
Restorelle , 114–115
SurgiMesh WN , 115, 116
Surgipro , 115
Surgipro, mono fi lamented , 117
Surgipro, multi fi lamented , 117
Surgipro Open Weave , 115, 117
TiMESH , 115, 117
Trelex mesh , 115
VitaMESH , 115
Polytetra fl uoroethylene (PTFE) , 110, 119, 144, 152–154, 156
Polyvinylidene fl uoride (PVDF) , 141, 143, 156
Porcine biologic prostheses
BioDesign Surgisis Hernia Grafts , 109, 110
CollaMend FM , 109
FortaGen , 109
Strattice , 109–110
XCM Biologic Tissue Matrix , 110
XenMatrix , 109, 110
PPV. See Patent processus vaginalis (PPV)
PrecisionPass Laparoscopic Delivery Device , 147, 150
ProTack , 146, 149
PVB. See Paravertebral block (PVB)
Q
Quality adjusted life years (QALYs) , 80–81, 85
R
Rectus sheath , 43–45
Recurrent hernias
CT scan , 224
laparoscopic repair , 278
Ugahary procedure , 270
Reverdin needle (RN) , 196
REVIVE mesh , 121
Ropivacaine , 162
S
Saccus vaginalis , 185
Safe Medical Devices Act of 1990 , 155
Sandwich technique
fascial defect , 380
Final intraperitoneal , 381
keyhole mesh placement , 381
ligamentum teres hepatis , 380
opened prevesical space , 380
Sugarbaker mesh placement , 381
Scanning electron microscopy (SEM) , 155
Sciatic hernia
anatomy , 318
clinical presentation , 318
treatment
mesh repair , 319
sac reduction , 319
transabdominal approach , 318
SEAL. See Subcutaneous endoscopically assisted ligation (SEAL)
SECURESTRAP , 146, 149
SFT. See Solitary fi brous tumor (SFT)
Shouldice repair
conjoint tendon , 241–242
evaluation and outcome , 242–243
external oblique aponeurosis , 242
fascia transversalis , 239–241
subcutaneous tissue and skin closure , 242
Skin incision , 234
Soft Tissue Patch , 119, 120
Solitary fi brous tumor (SFT) , 181
Spermatic cord , 50–51
Spigelian hernias
de fi nition and epidemiology , 302
history , 302–303
repair , 303–304
spigelian hernia belt , 302, 304
Sports hernias and athletic pubalgia
adductor pathology , 396, 397
clinical presentation , 395–396
diagnostic evaluation , 395
differential diagnosis
adductor muscle group strains , 394
athletic groin injuries , 395
groin pain , 393, 394
hip injuries , 394–395