Herniarrhaphy – Hernia Repair
Herniorrhaphy (Hernioplasty, Hernia repair) is a surgical procedure for correcting hernia. A hernia is a bulging of internal organs or tissues, which protrude through an abnormal opening in the muscle wall. Hernias can occur in the abdomen, groin, and at the site of a previous surgery.
Herniorraphy, or hernioplasty, is now often performed as an ambulatory, or “day surgery,” procedure. Almost 700,000 are performed each year in the United States. A workable technique of repairing hernia was first described by Bassini in the 1800s; the Bassini technique was a “tension” repair, in which the edges of the defect are sewn back together without any reinforcement or prosthesis. In the Bassini technique, the conjoint tendon (formed by the distal ends of the transversus abdominis muscle and the internal oblique muscle) is approximated to the inguinal canal and closed. Although tension repairs are no longer the standard of care due to the high rate of recurrence of the hernia, long recovery period, and post-operative pain, a few tension repairs are still in use today; these include the Shouldice and the Cooper’s Ligament/McVay repair. The Shouldice techniques is a complicated four layer reconstruction, however, it has very low reported recurrence rates (1%). An operation in which the hernia sac is removed in addition to tension repair is described as a ‘herniotomy’.
Surgical correction of inguinal hernias, called a herniorrhaphy or hernioplasty, is now often performed as an ambulatory, or “day surgery,” procedure. There are various surgical strategies which may be considered in the planning of inguinal hernia repair. These include the consideration of mesh use, type of open repair, use of laparoscopy, type of anesthesia, appropriateness of bilateral repair, etc. During surgery conducted under local anaesthesia, the patient will be asked to cough and strain during the procedure to help in demonstrating that the repair is “tension free” and sound.
Written by admin on November 17th, 2007 with
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