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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_961_Библиотеки_им_академика_М_И_Перельмана.pdf
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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
413Index
osteitis pubis , 394
stress fractures , 394
epidemiology , 393
marrow edema , 396
pathophysiology
athletic pubalgia , 398
external oblique aponeurosis , 398, 399
pubic joint , 397–398
surgical treatment
laparoscopic mesh repair , 401–403
Montreal technique , 401
Muschawek minimal repair technique , 400
open tension-free mesh repair , 400–401
outcomes of , 401–402
pathomechanics , 399
posterior inguinal fl oor defect , 401
postoperative rehabilitation protocol , 403
primary pelvic fl oor repair , 400
rehabilitation , 403–404
ultrasound , 397
Stat Tack , 146, 149
Stomal prostheses
CK Parastomal Patch , 143
Colostomy Mesh , 143
DynaMesh-IPST , 143
Easy Prosthesis (PPM/Collagen) , 143
Parietex Composite Parastomal Mesh , 144
Stomaltex , 144
TiLENE Guard , 144
Subcutaneous endoscopically assisted ligation (SEAL) , 197–198
Subcutaneous parastomal hernia repair , 372
Sugarbaker technique , 373, 375, 379–380
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
Supravesical hernia , 322–323
SurgiMend , 107, 108
Sutures
abdominal wound closure , 96–97
knots , 98
manipulation , 98
Marcy/Zimmermann suture repair , 238
natural and synthetic suture material , 94, 95
nonabsorbable sutures , 96
principles , 94
skin closure , 98–100
synthetic absorbable sutures , 95–96
Synthetic mesh
adverse events
biocompatibility , 155
complications , 156
contraction and migration , 155–156
FDA 510K application process , 154
mesh infection , 156
mesh ingrowth and adhesions , 156
biologic mesh , 157
clinical outcomes , 157
design
design parameters , 154
hernia mesh , 153–154
PET , 152–153
polypropylene , 152
PTFE , 153
history , 151–152
T
Tacker , 146, 149
Tension-free mesh repairs , 402
TiMESH , 115, 117, 118, 123, 126, 145
TiSURE , 145
Transabdominal hernia repair , 279–280
Transverse abdominal muscle , 39–40, 42
Traumatic lumbar hernia , 311, 313
Tunica vaginalis testis , 186
Tutomesh , 108
Tutopatch , 108
Type I hernias , 230
Type II hernias , 231
Type III hernias , 231
Type IV hernias , 231
U
Ugahary procedure , 265, 268–269
Umbilical hernia
age , 202
anterior abdominal wall , 201
cirrhosis , 306–307
clinical de fi nition, congenital umbilical hernia , 201
complicated umbilical hernias , 204–205
congenital umbilical hernias , 202
consent , 207
de fi nition and epidemiology , 305–306
diagnosis of , 206–207
epidemiology , 202
history , 201, 306
incarceration
appendicitis , 206
incidence of , 203
Meckel’s diverticulum , 206
outcomes , 206
prediction , 203
and strangulation , 203
incidental closure , 207
indications , 207
management options
anesthesia , 207
diagnostic work-up , 207
drapes , 207
incision , 207–208
level of evidence , 210–211
minimally invasive techniques , 210
observation , 207
patient position and prepping , 207
postoperative complications and treatment , 211
posttreatment course and postoperative care , 211
preoperative reduction , 207
sac dissection , 209–210
surgical options , 207
pathology, children , 201
Phoenician terracotta , 1, 2
physiology/natural history , 201–202
prematurity , 203
preternatural colon fi stula development , 3, 5
racial variation , 203
414 Index
Umbilical hernia (cont.)
recurrent incarceration , 206
repair , 307
rupture and evisceration , 206
Unilateral Wantz procedure , 261–262, 264–267
V
Vascular disease , 217
Veritas , 108
W
Willingness to pay (WTP) , 81–82
Wound healing , 92–94
X
XenMatrix , 109
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