Feasibility and limits of inguinal hernia repair under local anaesthesia in a limited resource environment: a prospective controlled study
AbstractPurposeLocal anaesthesia (LA) has proven effective for inguinal hernia repair in developed countries. Hernias in low to middle income countries represent a different issue. The aim of this study was to analyse the feasibility of LA for African hernia repairs in a limited resource environment.MethodsData from patients who underwent herniorrhaphy under LA or spinal anaesthesia (SA) by the 6th and 7th Forward Surgical Team were prospectively collected. All of the patients benefited from a transversus abdominis plane (TAP) block for postoperative analgesia. Primary endpoints concerned the pain response and conversion to general anaesthesia. Secondary endpoints concerned the complication and recurrence rates. Predictors of LA failure were then identified.ResultsIn all, 189 inguinal hernias were operated during the study period, and 119 patients fulfilled the inclusion criteria: 57 LA and 62 SA. Forty-eight percent of patients presented with inguinoscrotal hernias. Local anaesthesia led to more pain during surgery and necessitated more administration of analgesics but resulted in fewer micturition difficulties and better postoperative pain control. Conversion rates were not different. Inguinoscrotal hernia and a time interval
Walter Sebastian Nardi, Guido Luis Busnelli, Ariel Tchercansky, Daniel E Pirchi, Pablo José MedinaJournal of Minimal Access Surgery 2018 14(2):161-163A 63-year-old man with a history of a conventional cholecystectomy was referred to our department for an incisional subcostal hernia and chronic back pain. Physical examination also showed an umbilical hernia and diastasis recti measuring 6 cm that was confirmed with a computed tomography scan. Subcutaneous video-endoscopic repair was done repairing all defects simultaneously.
ConclusionsThe Rives technique requires a sound knowledge of inguinal preperitoneal space anatomy, but it is an excellent technique for the larger and difficult primary inguinal hernias, giving a low rate of recurrences and chronic pain.
While it can be uncomfortable for parents to talk about issues with their son’s private parts, abnormalities in the testicles and scrotum are common and treatable. One of my favorite parts of my job is sitting down with anxious families and being able to make the uncomfortable comfortable for them. I hope I can do that for you here in this guide to the most common testicular abnormalities seen in young boys. 1. Undescended testicles A baby boy should have two testicles down in the scrotum. The best time to examine your son is while he soaks in a warm bath. If you’re unable to see or feel ...
A powerful Instagram post is shedding light on the medical challenges that can follow childbirth and celebrating moms’ scars. Eighteen months ago, Kari Horn gave birth to her son via emergency C-section. Though becoming a parent has been a joyful experience for the Virginia mom, her postpartum journey involved umbilical hernias, more surgery and further complications. While recovering from these complications, Horn posted a striking photo of her abdomen on Instagram to share her story and remind other struggling moms that they are not alone. In the caption, Horn described her photo as one of “the part...
Discussion Varicoceles are caused by high venous back pressure which causes a tortuous dilatation of the testicular veins (pampiniform plexus) of the spermatic cord. They occur more on the left than right because the left renal vein has a higher pressure than the inferior vena cava which drain the left and right gonadal veins respectively. Varicoceles are not very common in young children (3% in
Conclusions: The “preperitoneal suction technique” seems useful to detect mesh dislocation and has potential to reduce TAPP-related complications.
This article looks at the question "why do some women "bounce back" and others don't when it comes to our abs post baby." Both of the following people did not have the abs they wanted despite doing abdominal exercises. Let's take a deeper look into what causes a pooch belly and diastasis (ab separation) and why some people easily have the abs they want! What is a diastasis? Read about it here, including a step by step diastasis check. Subject #1: "Cameron" Cameron came in to see me for hip pain and didn't know about an abdominal separation. After hearing a complaint of occasional recur...
Conclusion Our findings support the use of local anaesthetic in adult patients undergoing open repair for a primary inguinal hernia.
CONCLUSION: Inguinal hernias recurring after two or more failed conventional anterior and laparoscopic repairs can be safely and efficiently treated with SIL-IPOM. PMID: 25848186 [PubMed - in process]
CONCLUSION A surgeon may encounter a primary lumbar hernia perhaps once in his lifetime making it an interesting surgical challenge. Sound anatomical knowledge and adequate imaging are indispensable. Inspite of advances in minimally invasive surgery, it cannot be universally applied to patients with lumbar hernia and management requires a more tailored approach.