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The SAGES Manual
of Hernia Repair
The SAGES Manual
of Hernia Repair
Brian P. Jacob, MD, FACS
Mount Sinai School of Medicine, NY, USA
Bruce Ramshaw, MD, FACS
Transformative Care Institute, Daytona Beach, FL, USA
Editors
Editors
Brian P. Jacob, MD, FACS
Mount Sinai School of Medicine
Mount Sinai Medical Center
New York, NY, USA
Bruce Ramshaw, MD, FACS
Transformative Care Institute
Advanced Hernia Solutions
Department of General Surgery
Daytona Beach, FL, USA
ISBN 978-1-4614-4823-5 ISBN 978-1-4614-4824-2 (eBook)
DOI 10.1007/978-1-4614-4824-2
Springer New York Heidelberg Dordrecht London
Library of Congress Control Number: 2012948968
© Springer Science+Business Media New York 2013
This work is subject to copyright. All rights are reserved by the Publisher, whether the
whole or part of the material is concerned, specifically the rights of translation, reprinting,
reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other
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computer software, or by similar or dissimilar methodology now known or hereafter
developed. Exempted from this legal reservation are brief excerpts in connection with
reviews or scholarly analysis or material supplied specifically for the purpose of being
entered and executed on a computer system, for exclusive use by the purchaser of the work.
Duplication of this publication or parts thereof is permitted only under the provisions of the
Copyright Law of the Publisher’s location, in its current version, and permission for use
must always be obtained from Springer. Permissions for use may be obtained through
RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under
the respective Copyright Law.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this
publication does not imply, even in the absence of a specific statement, that such names are
exempt from the relevant protective laws and regulations and therefore free for general use.
While the advice and information in this book are believed to be true and accurate at the
date of publication, neither the authors nor the editors nor the publisher can accept any
legal responsibility for any errors or omissions that may 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)
v

Preface

The evolution of abdominal wall hernia repair, both inguinal and
ventral, continues as we begin the second decade of the twenty- fi rst
century. There is an ongoing in fl ux of new techniques, new prosthetics
and devices, and new hernia programs, each designed to optimize
outcomes for our patients. Tomorrow’s techniques and work fl ows will
certainly be different than those we are utilizing today. With patient
outcomes paramount, it is important to capture and summarize the
current trends and debates into one manual that is easily accessible for all
hernia surgeons. This new SAGES Manual of Hernia Repair provides
practicing surgeons with immediate access in one handbook to many
acceptable current ideas and strategies regarding hernia repair.
Each time we repair a hernia, the technique we choose and the mesh
we implant will vary, based not just on surgeon experience but also on
the individual patient we are trying to help. As surgeons lead the effort to
implement evidence-based algorithms to de fi ne and improve patient care
and outcomes, this manual can be used as a reference when considering
a particular management strategy for hernia patients. We have added a
unique section called Current Debates where readers can capture current
opinions on many of the ongoing debates of this time period.
We want to genuinely thank all of the contributors for their hard work in
preparing these manuscripts for this book, which we dedicate to all of the
family members and colleagues who unconditionally support each of us.
New York, NY, USA Brian P. Jacob
Daytona Beach, FL, USA Bruce Ramshaw
vii

Contents

Part I Essentials of Inguinal Hernia
1 Establishing a Hernia Program and Follow-Up Regimen:
A Complex Systems Design for Care and Improvement ......... 3
Bruce Ramshaw
2 Prosthetic Choice in Open Inguinal Hernia Repair .................. 19
Lisa C. Pickett
3 Prosthetic Choice in Laparoscopic Inguinal Hernia Repair ..... 27
Emily L. Albright and J. Scott Roth
Part II Techniques for Inguinal Hernia Repair
4 Technique: Lichtenstein ........................................................... 41
David C. Chen and Parviz K. Amid
5 Technique: Plug and Patch ....................................................... 55
Carl Doerhoff
6 Technique: Laparoscopic TEP ................................................. 71
Guy Voeller and Benjamin S. Powell
7 Technique: Laparoscopic TAPP and IPOM ............................. 81
William S. Cobb IV
8 Strangulated Inguinal Hernia ................................................... 91
Jonathan P. Pearl and E. Matthew Ritter
9 Femoral Hernia ......................................................................... 103
Daniel E. Swartz and Edward L. Felix
Part III Outcomes and Complications Following
Inguinal Hernia Repair
10 Results of Laparoscopic Repair of Inguinal Hernia ................. 117
Daniel Marcus
viii
Contents
11 Outcomes After Transabdominal Preperitoneal
Inguinal Hernia Repair ............................................................. 123
Nicole Fearing and Kimberly Ponnuru
12 Cord Structure Complications in Inguinal Hernia Surgery ...... 133
Aaron M. Lipskar and Mark A. Reiner
13 Intraoperative Complications During Laparoscopic
Hernia Repair ........................................................................... 143
Davide Lomanto and Rajat Goel
14 Urinary Retention After Laparoscopic Inguinal
Hernia Repair ........................................................................... 157
David A. McClusky III
15 Recurrent Inguinal Hernia: The Best Approach ....................... 167
Abe Fingerhut and Mousa Khoursheed
16 Athletic Groin Pain and Sports Hernia ..................................... 181
Nathaniel Stoikes and L. Michael Brunt
Part IV Current Debates in Inguinal Hernia Repair
17 TAPP vs. TEP ........................................................................... 197
Alfredo M. Carbonell II
18 Fixation Versus No Fixation in Laparoscopic TEP
and TAPP ................................................................................. 203
Viney K. Mathavan and Maurice E. Arregui
19 Laparoscopic Versus Open Repair for the
Uncomplicated Unilateral Inguinal Hernia .............................. 213
Pradeep Pallati and Robert J. Fitzgibbons Jr.
20 Polyester, Polypropylene, ePTFE for Inguinal Hernias:
Does It Really Matter? ............................................................. 231
Dmitry Oleynikov and Matthew Goede
Part V Essentials of Ventral and Incisional
Hernia Repair
21 Evolution of Incisional and Ventral Hernia Repair .................. 243
Malini D. Sur and L. Brian Katz
ix
Contents
22 Tissue Ingrowth: The Mesh–Tissue Interface:
What Do We Know So Far? ..................................................... 253
Gregory J. Mancini and A. Mariah Alexander
23 Patient Comorbidities Complicating a Hernia Repair:
The Preoperative Workup and Postoperative Planning ............ 271
Scott Philipp
24 What Is a Complex Abdominal Wall? ...................................... 283
Mickey M. Ott and Jose J. Diaz Jr.
Part VI Techniques for Ventral and Incisional
Hernia Repair
25 Synthetic Prosthetic Choices in Ventral Hernia Repair ............ 299
Sheila A. Grant
26 Biologic Prosthetics: What Are They
and How Do They Interact with the Body? ............................. 311
Gina L. Adrales and Elizabeth Honigsberg
27 Open Component Separation for Abdominal
Wall Reconstruction ................................................................. 323
David Earle
28 Endoscopic Component Separation ......................................... 333
Michael J. Rosen
29 Technique: Laparoscopic Ventral/Incisional Hernia Repair ..... 341
Archana Ramaswamy
30 Loss of Abdominal Domain ..................................................... 353
Victor B. Tsirline, Igor Belyansky, David A. Klima,
and B. Todd Heniford
31 Drains, Pain Pumps, and Abdominal Binders .......................... 371
Chris Edwards
Part VII Outcomes and Complications Following
Ventral and Incisional Hernia Repair
32 Skin Necrosis After Open Component Separation:
Prevention and Management .................................................... 381
Jignesh V. Unadkat and Dinakar Golla