Sonography of Hernias

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Sonography of Hernias"

Transcription

1 Sonography of Hernias Cindy Rapp BS, RDMS, FAIUM, FSDMS Sr. Clinical Marketing Manager Toshiba America Medical Systems Tustin, California What is a hernia? A hernia is a protrusion of an organ or tissue through an abnormal opening in the body. not all hernias contain bowel loops fat is the most common sonographic hernia content Where do hernias occur? Areas of natural weaknesses in our abdominal wall canals where plumbing goes through Internal inguinal ring and inguinal canal Femoral canal fetal canals - umbilical ring aponeroses direct inguinal, Spigelian, linea alba surgical scar Causes of hernias Increase in the intra-abdominal pressure obesity chronic coughing lifting heavy objects straining constipation pregnancy ascites Sonography can determine location (type) of hernia contents reducibility (dynamic maneuvers) strangulation Sonography of Hernias Abdominal Wall Hernias inguinal hernia direct indirect umbilical hernia femoral hernia spigelian hernia epigastric hypogastric Zarvan et al. 8 6 = linea alba epigastric 7 = linea alba hypogastric 8 = incisional 7 6 1

2 Sonography of Hernias Hernia contents: intraperitoneal fat fluid bowel vessels membranes properitoneal fat only incarceration bowel obstruction strangulation fat Hernia contents intraperitoneal fluid and bowel vessels and membranes hernia contents hernia contents shadowing gas within bowel peristalsing bowel hernia contents Hernia contents properitoneal / preperitoneal fat peritoneal membrane linea alba 2

3 Sonography of Hernias Indirect - long axis valsalva Dynamic maneuvers valsalva compression upright position some hernias present only during Valsalva indirect inguinal hernia compression dynamic maneuver upright Fat containing hernia - Supine Fat and fluid - upright Inguinal Hernia key to identifying internal inguinal ring = inferior epigastric vessels Key to diagnosis of inguinal hernias identify inferior epigastric vessels follow them to origin from EIA inferior epigastric origin marks the Internal Inguinal Ring long axis and short axis not longitudinal and transverse 3 3

4 Inferior Epigastric Vessels Inguinal Hernias Indirect inguinal hernia up and over (superficial) the inferior epigastric artery anterior to the spermatic cord (round ligament) may communicate with scrotum Direct inguinal hernia inferior to the internal inguinal ring through the conjoined tendon posterior to the spermatic cord trans left inguinal canal direct vs. indirect - spermatic cord short axis lt inguinal canal indirect indirect direct direct inguinal hernia indirect indirect inguinal hernia arises in the internal inguinal ring, superior, lateral, and passes anterior to the inferior epigastric artery adapted from Skandalakis et al. 4

5 indirect inguinal hernia long axis up and over inferior epigastric vessels indirect inguinal hernia short axis A A TRV RT ING CAN indirect inguinal hernias lie anterior to spermatic cord indirect inguinal hernia Not all are anterior to the SC in short axis compression of cord can cause pain radiating into scrotum indirect inguinal hernia indirect inguinal hernias wide neck configuration often has intraperitoneal contents narrow neck configuration often has only fat (may be called lipoma of spermatic cord) containing - fat and bowel 5

6 indirect inguinal hernias indirect inguinal hernia wide-neck indirect inguinal hernia containing - fat indirect inguinal hernias small fat-containing indirect inguinal hernia long axis - Valslava indirect inguinal hernia short axis - compression long indirect inguinal hernia containing bowel trans indirect inguinal hernia containing bowel 6

7 indirect inguinal hernia indirect inguinal hernia extending into scrotum inguinal hernia direct direct inguinal hernia A arises inferior and medial to and never passes anterior to the inferior epigastric artery adapted from Skandalakis et al. direct inguinal hernia -- short axis In many cases......thinning & bulging of conjoined tendon... thinning of the conjoined tendon SC...not an actual hole in tendon transverse left long valsalva long QR 7

8 direct inguinal hernia -- long axis direct inguinal hernia -- short axis A IEA sp cord hernia A sc direct inguinal hernias lie post. and med. to spermatic cord direct inguinal hernia compression of cord can cause pain radiating into scrotum arises inferior and medial to, and does not drape over inferior epigastic artery trans direct inguinal hernia long direct inguinal hernia 8

9 femoral hernias femoral hernia femoral hernia femoral hernia adapted from Skandalakis et al. femoral hernia femoral hernia 9

10 femoral hernia bilateral fat-containing spigelian hernias right femoral canal left femoral canal spigelian hernia spigelian hernia adapted from Skandalakis et al. tear of transversus abdominus sometimes internal oblique aponeurosis, external oblique intact left spigelian hernia fat containing partially reducible Ext obliq Int obliq Transv abd Rectus 10

11 left spigelian hernia fat & bowel containing partially reducible Spigelian vs. indirect inguinal hernias ventral hernias epigastric hypogastric linea alba hernia epigastric or hypogastric adapted from Skandalakis et al. linea alba hernia properitoneal Epigastric - linea alba hernia non-reducible, non-strangulated properitoneal fat only 11

12 epigastric hernia properitoneal fat non-reducible multiple epigastric hernia s mesh epigastric hernia reducible umbilical hernias umbilical hernia umbilical hernia supine valsalva 12

13 umbilical hernia umbilical hernia bowel, fat and fluid partially reducible Strangulated fat Normal fat recurrent or residual pain after surgical hernia repair occurs more commonly than thought many causes recurrent hernia seroma, hematoma, abscess repair too tight reaction to mesh tender spiral clips scar ilioinguinal nerve entrapment (default dx) acute & subacute herniorraphy complications hematoma compression of spermatic cord and testicular ischemia seroma stitch abscess acute post-herniorraphy hematoma acute post-herniorraphy seroma 13

14 subacute post herniorrhpahy stitch abscess herniorrhaphy mesh hernia occurs from edges of mesh most likely detached edge most often infero-medial edge all this means that we must try to identify the mesh sonographically recurrent hernias after repair with mesh Hernia repair mesh not classified as direct or indirect arise from edge of mesh -interrogate entire margin of mesh dynamically most frequently from infero-lateral edge of mesh typically clip has come loose and mesh has retracted superiorly lower edge of mesh often appears too high well above internal inguinal ring and conjoined tendon can arise from any edge tender during compression Trans LLQ Long LLQ many different types of mesh sonographic appearance varies recurrent inguinal hernia at inferior edge of mesh 14

15 recurrent hernias arise from edge of mesh Recurrent hernia edge of mesh mesh can bulge normally eccentric bulge to this degree typically is associated with recurrent hernia spiral clips post herniorrhaphy tender spiral clip at edge of mesh 15

16 Palpable Diastasis Recti Hernia sonography 43 year old female, left groin pain. R/O hernia long left inguinal canal long left inguinal canal IEA Valsalva Compression long left inguinal canal Bilateral round ligament varices supine upright LEFT round ligament varices 16

17 significance of incidence of multiple hernias to diagnostic imagers How a report reads exam type, indications, and technique if a hernia detected: look for additional hernias of other types ipsilaterally look for mirror image hernias contralaterally some types of hernias are frequently bilateral femoral direct inguinal > indirect inguinal Spigelian look for additional hernias aponeurosis multiple epigastric hernias exam: dynamic ultrasound of bilateral groin indication: right groin pain / lump procedure: bilateral dynamic sonographic evaluation of the groin was performed with the patient in both supine and upright positions and with and without compression and Valsalva maneuvers how a report reads: (primary findings) There is a small right fat containing non-reducible indirect inguinal hernia that is... tender when compressed. (size) (side) (contents) (reducibility) (type) (tenderness) The End 17

Hernia KIM MYOUNG SOO M.D. Department of Surgery Yonsei University Wonju College of Medicine

Hernia KIM MYOUNG SOO M.D. Department of Surgery Yonsei University Wonju College of Medicine 4 Hernia KIM MYOUNG SOO M.D. Department of Surgery Yonsei University Wonju College of Medicine ysms91@wonju.yonsei.ac.kr http://gs.yonsei.ac.kr 1..(B) 2..(B) 3..(A) 4. (Hesselbach's striangle).(b) 5.,.(A)

More information

Inguinal Hernia - Quiz:

Inguinal Hernia - Quiz: Inguinal Hernia - Quiz: 1. This section of the quiz is composed of 8 questions relating to the development of the inguinal canal. 1) What is the inguinal canal created by: An outpouching of peritoneum

More information

Sliding Hernias Jason Levine MD Brooklyn VA May 6 th 2010

Sliding Hernias Jason Levine MD Brooklyn VA May 6 th 2010 Sliding Hernias Jason Levine MD Brooklyn VA May 6 th 2010 CASE PRESENTATION 66 YO M No PMH/PSH Enlarging right inguinal scrotal hernia x several years Painful but reducible PHYSICAL EXAM AF VSS Gen Comfortable

More information

Abdominal wall hernia

Abdominal wall hernia 8 Abdominal wall hernia Key Points 8.1 GROIN HERNIAS Inguinal hernia bulges above the inguinal ligament, with the hernia neck above and medial to the pubic tubercle Inguinal hernia is most common in males

More information

The Abdominal Wall And Hernias. Stanley Kurek, DO, FACS Associate Professor of Surgery UTMCK

The Abdominal Wall And Hernias. Stanley Kurek, DO, FACS Associate Professor of Surgery UTMCK The Abdominal Wall And Hernias Stanley Kurek, DO, FACS Associate Professor of Surgery UTMCK The Abdominal Wall The structure of the abdominal wall is similar in principle to the thoracic wall. There are

More information

Groin Hernias. Presley Regional Trauma Center Department of Surgery University of Tennessee Health Science Center Memphis, Tennessee

Groin Hernias. Presley Regional Trauma Center Department of Surgery University of Tennessee Health Science Center Memphis, Tennessee Groin Hernias Presley Regional Trauma Center Department of Surgery University of Tennessee Health Science Center Memphis, Tennessee Background Approximately 20 million groin hernias are repaired each year

More information

Incarcerated Hernia: Non-reducible. The contents of the hernia cannot be returned to its normal location.

Incarcerated Hernia: Non-reducible. The contents of the hernia cannot be returned to its normal location. Hernia What is a hernia? Hernia is derived from the Latin for "rupture" and is the protrusion of an organ or part of an organ or other structure tough the wall of the cavity normally containing it. Sir

More information

INFORMATION FOR PATIENTS CONSIDERING LAPAROSCOPIC INGUINAL HERNIA REPAIR

INFORMATION FOR PATIENTS CONSIDERING LAPAROSCOPIC INGUINAL HERNIA REPAIR INFORMATION FOR PATIENTS CONSIDERING A LAPAROSCOPIC INGUINAL HERNIA REPAIR Prepared By Mr Peter Willson Consultant Surgeon Contents 1. Background... 3 2. What is an inguinal Hernia?... 3 3. What are the

More information

Surgery General Surgery Hx and Ex of HERNIA

Surgery General Surgery Hx and Ex of HERNIA Surgery General Surgery Hx and Ex of HERNIA A. Overview: A hernia occurs when an organ pushes through an opening in the muscle or tissue that holds it in place. For example, the intestines may break through

More information

Inguinal Hernia (Female)

Inguinal Hernia (Female) Inguinal Hernia (Female) WHAT IS AN INGUINAL HERNIA? 2 WHAT CAUSES AN INGUINAL HERNIA? 2 WHAT DOES TREATMENT / MANAGEMENT INVOLVE? 3 DAY SURGERY MANAGEMENT 3 SURGICAL REPAIR 4 WHAT ARE THE RISKS/COMPLICATIONS

More information

Inguinal Hernia Repair. Saeed Awan

Inguinal Hernia Repair. Saeed Awan Inguinal Hernia Repair Saeed Awan No disease of human body, belonging to the province of surgeon, requires in its treatment, a better combination of accurate anatomical knowledge with surgical skill than

More information

Laparoscopic Repair of Hernias. A simple guide to help answer your questions

Laparoscopic Repair of Hernias. A simple guide to help answer your questions Laparoscopic Repair of Hernias A simple guide to help answer your questions What is a hernia? A hernia is defined as a hole or defect in the abdominal (belly) wall. A hernia can either be congenital (a

More information

Absite Review Series Hernias II Abdominal Wall Hernia Ravi Dhanisetty, M.D. SUNY Downstate 7/11/2008 ACGME Core Competencies Mdi Medical lk Knowledge ld Patient Care Interpersonal Skills Practice Based

More information

Anatomy of the Inguinal and Femoral Canals TEPP view of hernias. Mon 5 th Mar 2012, 0700-0730hrs

Anatomy of the Inguinal and Femoral Canals TEPP view of hernias. Mon 5 th Mar 2012, 0700-0730hrs Anatomy of the Inguinal and Femoral Canals TEPP view of hernias Mon 5 th Mar 2012, 0700-0730hrs Scope of Session Spot Test (0700-0705hr) Anatomy of Inguinal Canal (0705-0710hr) Anatomy of Femoral Canal

More information

Femoral Hernia Repair

Femoral Hernia Repair Femoral Hernia Repair WHAT IS A FEMORAL HERNIA REPAIR? 2 WHAT CAUSES A FEMORAL HERNIA? 2 WHAT DOES TREATMENT/ MANAGEMENT INVOLVE? 3 DAY SURGERY MANAGEMENT 3 SURGICAL REPAIR 4 WHAT ARE THE RISKS/COMPLICATIONS

More information

BJUI. Surgery Illustrated Surgical Atlas The Shouldice natural tissue repair for inguinal hernia

BJUI. Surgery Illustrated Surgical Atlas The Shouldice natural tissue repair for inguinal hernia 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 SHOULDICE BJUI BJU INTERNATIONAL Surgery Illustrated Surgical Atlas The Shouldice natural tissue repair for inguinal hernia Earle Byrnes Shouldice Shouldice Hospital, Thornhill,

More information

HERNIA, ABDOMINAL Includes Inguinal, Femoral, Umbilical, and Ventral Hernias; Includes Abdominal Wall Hernia Repair.

HERNIA, ABDOMINAL Includes Inguinal, Femoral, Umbilical, and Ventral Hernias; Includes Abdominal Wall Hernia Repair. 1 GI 7 HERNIA, ABDOMINAL Includes Inguinal, Femoral, Umbilical, and Ventral Hernias; Includes Abdominal Wall Hernia Repair. Background This case definition was developed by the Armed Forces Health Surveillance

More information

FREEDOM INGUINAL Hernia Repair System TECHNIQUE GUIDE

FREEDOM INGUINAL Hernia Repair System TECHNIQUE GUIDE FREEDOM INGUINAL Hernia Repair System TECHNIQUE GUIDE The following describes the open surgical preparation and implantation technique for the Freedom Inguinal Hernia Repair System. 1) Anesthesia can be

More information

Abdominal Wall Hernias

Abdominal Wall Hernias Abdominal Wall Hernias Definition Protrusion of a viscus through an opening in the wall of the cavity in which it is contained The size of a hernia is determined by the dimension of the neck and the volume

More information

Abdominal Wall Hernias: Classic and Unusual

Abdominal Wall Hernias: Classic and Unusual Abdominal Wall Hernias: Classic and Unusual Arash Bedayat, MD; Hemang Kotecha, DO; Matthew L. Hoimes, MD; Byron Y. Chen, MD; Hao S. Lo, MD; Adib R. Karam, MD Objectives Review the radiologic anatomy and

More information

Inguinal hernia in infancy and childhood

Inguinal hernia in infancy and childhood Inguinal hernia in infancy and childhood Giorgio Bozzini Academic Division of Urology, IRCCS Policlinico San Donato, University of Milan H.Dep: prof. L. Carmignani Today, inguinal hernia repair is one

More information

Healthletter. Hernias They Should not be Ignored. August 2009

Healthletter. Hernias They Should not be Ignored. August 2009 Healthletter August 2009 Hernias They Should not be Ignored Did you know that over five million Americans suffer from some type of hernia? For many of these people, this condition causes substantial pain

More information

The TV Series. www.healthybodyhealthymind.com INFORMATION TELEVISION NETWORK

The TV Series. www.healthybodyhealthymind.com INFORMATION TELEVISION NETWORK The TV Series www.healthybodyhealthymind.com Produced By: INFORMATION TELEVISION NETWORK ONE PARK PLACE 621 NW 53RD ST BOCA RATON, FL 33428 1-800-INFO-ITV www.itvisus.com 2005 Information Television Network.

More information

External Abdominal Hernias

External Abdominal Hernias Discussion paper prepared for The Workplace Safety and Insurance Appeals Tribunal January 2006 Prepared by: Dr. John H. Duff Professor Emeritus Department of Surgery University of Western Ontario Dr. John

More information

10/10/2013. Pediatric Hernias: When to Refer. Disclosures. Outline. Nothing to disclose. Inguinal Hernias. Epigastric Hernias.

10/10/2013. Pediatric Hernias: When to Refer. Disclosures. Outline. Nothing to disclose. Inguinal Hernias. Epigastric Hernias. Pediatric Hernias: When to Refer Katrina Cardenas, MMS, PA-C October 12, 2013 http://lifestyle-advertising-photographer-la.blogspot.com/ Disclosures Nothing to disclose Outline Inguinal Hernias Epigastric

More information

Expert Review Examination of Groin Hernias

Expert Review Examination of Groin Hernias Expert Review Examination of Groin Hernias Laurence Toms*, Sam Mathew Lynn and Ashok Handa #.. The Journal of Clinical Examination 2011 (11): 32-43 Abstract Examination of groin hernias is an important

More information

Transcript Slide 1 Introduction slide: Slide 2 Anterior abdominal wall borders: Slide 3 Surface markings:

Transcript Slide 1 Introduction slide: Slide 2 Anterior abdominal wall borders: Slide 3 Surface markings: Transcript Slide 1 Introduction slide: This presentation will discuss the anatomy of the anterior abdominal wall as it pertains to gynaecological and obstetric surgery. Slide 2 Anterior abdominal wall

More information

Dr. Mark Conway MD FACOG V.P. Society for Pudendal Neuralgia

Dr. Mark Conway MD FACOG V.P. Society for Pudendal Neuralgia Dr. Mark Conway MD FACOG V.P. Society for Pudendal Neuralgia About 60 Kilometers North of Boston Community Hospital Population of surrounding area 150,000 Several Teaching and University hospitals within

More information

Facing a Hernia Repair? Learn about minimally invasive da Vinci Surgery

Facing a Hernia Repair? Learn about minimally invasive da Vinci Surgery Facing a Hernia Repair? Learn about minimally invasive da Vinci Surgery The Condition: Hernia A hernia happens when part of an organ or tissue bulges through a hole or weak area in the belly wall (fascia).

More information

2/9/2013. Objectives. The Surgical Approach to Sports Hernia: Myth or Reality. Discuss epidemiology of athletic groin injuries

2/9/2013. Objectives. The Surgical Approach to Sports Hernia: Myth or Reality. Discuss epidemiology of athletic groin injuries Kent W. Kercher, MD, FACS Chief Minimal Access Surgery Professor of Surgery Division of GI and Minimally Invasive Surgery Carolinas Medical Center Charlotte, North Carolina Brent D. Matthews, MD L. Michael

More information

Breast Sonography general goal. Optimizing Breast Sonography. BUS indications -- all. Breast Sonography specific goals.

Breast Sonography general goal. Optimizing Breast Sonography. BUS indications -- all. Breast Sonography specific goals. Optimizing general goal Cindy Rapp BS, RDMS, FAIUM, FSDMS University of Colorado Hospital Denver, Colorado to make a more specific diagnosis than can be made with clinical and mammographic findings alone

More information

Inguinal Hernia. National Digestive Diseases Information Clearinghouse

Inguinal Hernia. National Digestive Diseases Information Clearinghouse Inguinal Hernia National Digestive Diseases Information Clearinghouse U.S. Department of Health and Human Services NATIONAL INSTITUTES OF HEALTH What is inguinal hernia? An inguinal hernia is a condition

More information

A Rare Variant of Inguinal Hernia, Interparietal Hernia and Ipsilateral Abdominal Ectopic Testis, Mimicking a Spiegelian Hernia.

A Rare Variant of Inguinal Hernia, Interparietal Hernia and Ipsilateral Abdominal Ectopic Testis, Mimicking a Spiegelian Hernia. Tokai J Exp Clin Med., Vol. 38, No. 2, pp. 77-81, 2013 A Rare Variant of Inguinal Hernia, Interparietal Hernia and Ipsilateral Abdominal Ectopic Testis, Mimicking a Spiegelian Hernia. Case Report Takeshi

More information

Contents. 1. Milestones in Hernia Surgery 1. 2. Surgical Anatomy of Hernia Sites 5. 3. Incidence, Prevalence of Hernia 32

Contents. 1. Milestones in Hernia Surgery 1. 2. Surgical Anatomy of Hernia Sites 5. 3. Incidence, Prevalence of Hernia 32 1. Milestones in Hernia Surgery 1 History of the Procedure 3 2. Surgical Anatomy of Hernia Sites 5 Surgical Anatomy of Hernia Sites 5 External Anatomy of Abdominal Wall The Surface Markings 6 The Fascia

More information

Amir Kashefi 1, MD Marc A Friedman 1, MD Alan V Krauthamer 1, MD Anthony G Gilet 1, MD Bijan Bijan 2, MD, MBA

Amir Kashefi 1, MD Marc A Friedman 1, MD Alan V Krauthamer 1, MD Anthony G Gilet 1, MD Bijan Bijan 2, MD, MBA Amir Kashefi 1, MD Marc A Friedman 1, MD Alan V Krauthamer 1, MD Anthony G Gilet 1, MD Bijan Bijan 2, MD, MBA 1. Harlem Hospital Center, Radiology Dep. 506 Lenox Ave, New York, NY 10037 2. UC Davis Medical

More information

Laparoscopic hernia repair GEORGIOS SAMPALIS GENERAL SURGEON. Director of surgical department of Lefkos Stavros of Athens

Laparoscopic hernia repair GEORGIOS SAMPALIS GENERAL SURGEON. Director of surgical department of Lefkos Stavros of Athens Laparoscopic hernia repair GEORGIOS SAMPALIS GENERAL SURGEON Director of surgical department of Lefkos Stavros of Athens About 600,000 surgical hernia repair procedures are performed every year... Many

More information

KEYHOLE HERNIA SURGERY

KEYHOLE HERNIA SURGERY Disclaimer This movie is an educational resource only and should not be used to manage a hernia or abdominal pain. All decisions about the management of a hernia must be made in conjunction with your Physician

More information

Inguinal hernia repair

Inguinal hernia repair Inguinal hernia repair A hernia is an abnormal protrusion on an organ through a weakness in the abdominal wall. The abdominal muscles are usually strong enough to keep your internal organs in place, when

More information

Non-mesh repair of adult inguinal hernia: a simple solution

Non-mesh repair of adult inguinal hernia: a simple solution Original Article Non-mesh repair of adult inguinal hernia: a simple solution ABSTRACT Objective Shaukat Ali Sheikh,* Mohammad Iqbal,** Nauman Mustafa,*** Ihtasham Muhammad Ch.,# Umer Farooq,*** Yasir Mehmood#

More information

Facing a Hernia Repair? Learn about minimally invasive da Vinci Surgery

Facing a Hernia Repair? Learn about minimally invasive da Vinci Surgery Facing a Hernia Repair? Learn about minimally invasive da Vinci Surgery The Condition: Hernia A hernia happens when part of an internal organ or tissue bulges through a hole or weak area in the belly wall

More information

Facing a Hernia Repair? Learn about minimally invasive da Vinci Surgery

Facing a Hernia Repair? Learn about minimally invasive da Vinci Surgery Facing a Hernia Repair? Learn about minimally invasive da Vinci Surgery The Condition: Hernia A hernia happens when part of an internal organ or tissue bulges through a hole or weak area in the belly wall

More information

Laparoscopic Inguinal Hernia Repair Surgery Patient Information from SAGES

Laparoscopic Inguinal Hernia Repair Surgery Patient Information from SAGES Laparoscopic Inguinal Hernia Repair Surgery Patient Information from SAGES About Your Inguinal Hernia and Laparoscopic Repair: Approximately 600,000 inguinal or groin hernia repair operations are performed

More information

Bard * PerFix * Plug. Technique Guide. A Modified Technique with the. Open Inguinal Hernia Repair

Bard * PerFix * Plug. Technique Guide. A Modified Technique with the. Open Inguinal Hernia Repair A Modified Technique with the Bard * PerFix * Plug A quick and simple preperitoneal underlay Modified Technique for the repair of groin hernias Technique Guide Open Inguinal Hernia Repair This technique,

More information

The use of mesh in hernia repair, risk management and the advantages of day surgery

The use of mesh in hernia repair, risk management and the advantages of day surgery Middle East Journal of Family Medicine, 2004; Vol. 3 (3) The use of mesh in hernia repair, risk management and the advantages of day surgery Maurice Brygel, "Hernia King" Lecturer University of Melbourne,

More information

M O V I N G F R E E LY. HerniaCenter. The Columbia Hernia Center at ColumbiaDoctors Midtown

M O V I N G F R E E LY. HerniaCenter. The Columbia Hernia Center at ColumbiaDoctors Midtown M O V I N G F R E E LY HerniaCenter The Columbia Hernia Center at ColumbiaDoctors Midtown Director, Dr. Peter L. Geller The Columbia Hernia Center brings together a group of surgeons adept in using the

More information

First laparoscopic inguinal hernia repair performed by Ger in 1970s (published in 1982) Schultz described the TAPP repair in 1990

First laparoscopic inguinal hernia repair performed by Ger in 1970s (published in 1982) Schultz described the TAPP repair in 1990 Introduction First laparoscopic inguinal hernia repair performed by Ger in 1970s (published in 1982) Schultz described the TAPP repair in 1990 McKernon and Laws described the TEP repair in 1993 Currently,

More information

Internet Journal of Medical Update

Internet Journal of Medical Update Internet Journal of Medical Update 2010 January;5(1):29-34 Internet Journal of Medical Update Journal home page: http://www.akspublication.com/ijmu Original Work A Different Technique of Primary Indirect

More information

Abdominal Hernia Repair (page 1 of 4) i

Abdominal Hernia Repair (page 1 of 4) i Abdominal Hernia Repair (page 1 of 4) i If you need this information in another language or medium (audio, large print, etc) please contact Customer Care Team on 0800 374 208 or send an email to: customercare@

More information

X-Plain Inguinal Hernia Repair Reference Summary

X-Plain Inguinal Hernia Repair Reference Summary X-Plain Inguinal Hernia Repair Reference Summary Introduction Hernias are common conditions that affect men and women of all ages. Your doctor may recommend a hernia operation. The decision whether or

More information

Inguinal Hernia: Repair is preferred. John James UCDenver HSC SOM Surgical Grand Rounds 2/13/12

Inguinal Hernia: Repair is preferred. John James UCDenver HSC SOM Surgical Grand Rounds 2/13/12 Inguinal Hernia: Repair is preferred John James UCDenver HSC SOM Surgical Grand Rounds 2/13/12 Inguinal Hernia A sac formed from the peritoneum and containing a portion of the intestine or omentum, or

More information

Sports Hernia Diagnosis and Treatment. Seth M. Weinreb, MD, FACS December 6, 2014

Sports Hernia Diagnosis and Treatment. Seth M. Weinreb, MD, FACS December 6, 2014 Sports Hernia Diagnosis and Treatment Seth M. Weinreb, MD, FACS December 6, 2014 My story Hernia surgeon, Hernia patient Soccer Typical right inguinal hernia repair in college Training general surgery

More information

Hernias in Small Animals. Surgery of Hernias in Small Animals

Hernias in Small Animals. Surgery of Hernias in Small Animals Hernias in Small Surgery of Hernias in Small T. Németh, DVM, PhD Hernias in Small Hernias in Small Umbilical Inguinal Traumatic abdominal Perineal Hernias in Small Hernias in Small Umbilical Inguinal Traumatic

More information

Spigelian Hernia Repair

Spigelian Hernia Repair Spigelian Hernia Repair WHAT IS A SPIGELIAN HERNIA? 2 WHAT CAUSES IT? 2 WHAT DOES TREATMENT/ MANAGEMENT INVOLVE? 2 WHAT WOULD HAPPEN IF THE HERNIA WAS NOT TREATED? 2 SPIGELIAN HERNIA REPAIR 3 WHAT ARE

More information

Inguinal (Groin) Hernia Repair

Inguinal (Groin) Hernia Repair Information for patients Inguinal (Groin) Hernia Repair General Surgery Tel: 01473 712233 DMI ref: 11582-09.indd(RP) Issue 1: February 2010 The Ipswich Hospital NHS Trust, 2010. All rights reserved. Not

More information

Reimbursement Guide: Hernia and Abdominal Wall Repair

Reimbursement Guide: Hernia and Abdominal Wall Repair For more information Ask your Covidien sales representative how procedural solutions for hernia repair can enhance your specialty. Call 1-800-722-8772 today to order product brochures, DVDs or detailed

More information

Hernias. Faculty of Medicine, University of British Columbia Department of Surgery Division of General Surgery

Hernias. Faculty of Medicine, University of British Columbia Department of Surgery Division of General Surgery Hernias Faculty of Medicine, University of British Columbia Department of Surgery Division of General Surgery Photography: D.B. Allardyce MD FRCS Text and Technical assistance: Ryan Janicki med 2006 Introduction

More information

LAPAROSCOPIC SURGICAL CODING THROUGH THE EYES OF THE SURGEON

LAPAROSCOPIC SURGICAL CODING THROUGH THE EYES OF THE SURGEON LAPAROSCOPIC SURGICAL CODING THROUGH THE EYES OF THE SURGEON PRESENTED BY: JEANNE PLOUFFE, CPC, CGSC Today s presentation you will see video of actual laparoscopic surgery for hernia defects, df diseased

More information

Objectives. Hesselbach s Triangle 5/5/2010. Myopectineal Orifice of Fruchaud. Hernias: Who, What, When, Where, Why?

Objectives. Hesselbach s Triangle 5/5/2010. Myopectineal Orifice of Fruchaud. Hernias: Who, What, When, Where, Why? Objectives Hernias: Who, What, When, Where, Why? J. Scott Roth, MD Chief, Gastrointestinal Surgery Director, Minimally Invasive Surgery University of Kentucky June 16, 2009 Identify patients at risk for

More information

Synopses of Causation

Synopses of Causation Ministry of Defence Synopses of Causation Hernia Author: Dr Kimberley Jensen, Medical Author, Medical Text, Edinburgh Validator: Professor G Layer, Royal Surrey County Hospital, Guildford Disclaimer This

More information

PATIENT INFORMATION Laparoscopic (Keyhole) Inguinal Hernia Repair

PATIENT INFORMATION Laparoscopic (Keyhole) Inguinal Hernia Repair PATIENT INFORMATION Laparoscopic (Keyhole) Inguinal Hernia Repair Please use this space to make a note of any questions you wish to ask: Laparoscopic (Keyhole) Inguinal Hernia Repair The Spencer Private

More information

Mesh Plug Repair of Inguinal Hernias. Presented by: V.K Ashok, M.D, F.A.C.S

Mesh Plug Repair of Inguinal Hernias. Presented by: V.K Ashok, M.D, F.A.C.S Mesh Plug Repair of Inguinal Hernias Presented by: V.K Ashok, M.D, F.A.C.S April 2, 2011 About V.K. Ashok, M.D Practicing general and vascular surgeon in private practice based in Freehold, NJ for the

More information

OPEN ACCESS TEXTBOOK OF GENERAL SURGERY

OPEN ACCESS TEXTBOOK OF GENERAL SURGERY OPEN ACCESS TEXTBOOK OF GENERAL SURGERY HERNIA JHR Becker DEFINITION A hernia is a prolapse of the membrane lining a cavity due to a defect in the wall of the cavity. The abdominal cavity is the most common

More information

27 OPEN HERNIA REPAIR

27 OPEN HERNIA REPAIR 27 OPEN HERNIA REPAIR 27 Open Hernia Repair 1 Robert J. Fitzgibbons, Jr., M.D., F.A.C.S., Alan T. Richards, M.D., F.A.C.S., and Thomas H. Quinn, Ph.D. Herniorrhaphy is one of the most commonly performed

More information

Surgical treatment of groin pain in athletes

Surgical treatment of groin pain in athletes Surgical treatment of groin pain in athletes (One of) The French approach Dr Christian LUTZ* 6th Sports Medicine Workshop Luxembourg, 03.12.2011 *Clinique du Diaconat Strasbourg - FRANCE Interest of a

More information

Compression US for DVT

Compression US for DVT Compression US for DVT 1 Anatomy Below the knee, the veins listed below are traditionally imaged to exclude DVT. This process is time consuming and requires expertise beyond the scope of this course. Anterior

More information

Morbidity and Mortality Hernia Repair. Kings County Hospital August 18, 2006 Joelle Pierre

Morbidity and Mortality Hernia Repair. Kings County Hospital August 18, 2006 Joelle Pierre Morbidity and Mortality Hernia Repair Kings County Hospital August 18, 2006 Joelle Pierre Case Presentation xx y/o male with h/o ESRD presented to Kings County Hospital for repair of a right inguinal hernia

More information

Laparoscopic Hernia Repair. Hernia Repair. Laparoscopic Ventral. Several Different Types of Hernia

Laparoscopic Hernia Repair. Hernia Repair. Laparoscopic Ventral. Several Different Types of Hernia Laparoscopic Hernia Repair David B Renton, MD Assistant Professor Department of Surgery The Ohio State University Advantages of Laparoscopic Ventral vs. Open Hernia Repair Lower wound infection rate: 2.6%

More information

ONSTEP Technique. Technique Guide * Anterior Approach to a Part Preperitoneal, Part Intramuscular Inguinal Hernia Repair

ONSTEP Technique. Technique Guide * Anterior Approach to a Part Preperitoneal, Part Intramuscular Inguinal Hernia Repair ONSTEP Technique Technical Aspects of the ONSTEP Inguinal Hernia Repair Technique Using the PolySoft Hernia Patch with Interrupted Memory Recoil Ring Technique Guide * Anterior Approach to a Part Preperitoneal,

More information

Clinical Anatomy of the Biliary Apparatus: Relations & Variations

Clinical Anatomy of the Biliary Apparatus: Relations & Variations Clinical Anatomy of the Biliary Apparatus: Relations & Variations Handout download: http://www.oucom.ohiou.edu/dbms-witmer/gs-rpac.htm 24 January 2012 Lawrence M. Witmer, PhD Professor of Anatomy Department

More information

How to treat. Abdominal wall hernias. inside Symptoms and signs of hernias. Get control Keep control. Pull-out section. Background

How to treat. Abdominal wall hernias. inside Symptoms and signs of hernias. Get control Keep control. Pull-out section. Background How to treat Pull-out section Earn CPD points on page 36 Background www.australiandoctor.com.au Complete How to Treat quizzes online (www.australiandoctor.com.au/cpd) or in every issue. inside Symptoms

More information

C A R O L I N A S. Hernia Handbook ( C H A P T E R 2 ) B. Todd Heniford, MD

C A R O L I N A S. Hernia Handbook ( C H A P T E R 2 ) B. Todd Heniford, MD C A R O L I N A S Hernia Handbook ( C H A P T E R 2 ) B. Todd Heniford, MD C H A P T E R 2 Umbilical Hernias C A R O L I N A S H E R N I A H A N D B O O K 17 Umbilical Hernias W H AT I S A N U M B I L

More information

Laparoscopic total extraperitoneal repair for incarcerated inguinal hernia

Laparoscopic total extraperitoneal repair for incarcerated inguinal hernia J Korean Surg Soc 2011;80:426-430 DOI: 10.4174/jkss.2011.80.6.426 ORIGINAL ARTICLE JKSS Journal of the Korean Surgical Society pissn 2233-7903 ㆍ eissn 2093-0488 Laparoscopic total extraperitoneal repair

More information

History. Sports hernia: Diagnosis and treatment. Sports hernia - a description. Sports hernia?

History. Sports hernia: Diagnosis and treatment. Sports hernia - a description. Sports hernia? Sports hernia: Diagnosis and treatment Per Hölmich Sports Groin Pain Center Aspetar Orthopaedic and Sports Medicine Hospital Doha, Qatar & The Copenhagen Groin and Hip Research Center Arthroscopic Center

More information

LAPAROSCOPIC OR KEYHOLE REPAIR OF VENTRAL (INCISIONAL) HERNIA

LAPAROSCOPIC OR KEYHOLE REPAIR OF VENTRAL (INCISIONAL) HERNIA LAPAROSCOPIC OR KEYHOLE REPAIR OF VENTRAL (INCISIONAL) HERNIA Information Leaflet Your Health. Our Priority. Page 2 of 6 Laparoscopic or Keyhole repair of Ventral (incisional) hernias Many ventral hernias

More information

28 LAPAROSCOPIC HERNIA REPAIR

28 LAPAROSCOPIC HERNIA REPAIR 28 Laparoscopic Hernia Repair 1 28 LAPAROSCOPIC HERNIA REPAIR Liane S. Feldman, M.D., F.A.C.S., Marvin J.Wexler, M.D., F.A.C.S., and Shannon A. Fraser, M.D. Since its first description in 1990, 1 laparoscopic

More information

Technical Guidance for Surgical Workload Audit and Research Database: Hernia V1.0

Technical Guidance for Surgical Workload Audit and Research Database: Hernia V1.0 Technical Guidance for Surgical Workload Audit and Research Database: Hernia V1.0 Contents 1. The Indicators... 3 1.1. Activity Volume... 3 3.2. Average Length of Stay (Days)... 3 3.3. 2/7/30 day Re-admission

More information

Beverly E Hashimoto, M.D. Virginia Mason Medical Center, Seattle, WA

Beverly E Hashimoto, M.D. Virginia Mason Medical Center, Seattle, WA Pelvic Floor Relaxation Beverly E Hashimoto, M.D. Virginia Mason Medical Center, Seattle, WA Disclosures Beverly Hashimoto: GE Medical Systems: research support and consultant (all fees given to Virginia

More information

Incisional, Ventral Hernia Repair

Incisional, Ventral Hernia Repair Incisional, Ventral Hernia Repair Introduction Hernias are common conditions that affect men and women of all ages. Your doctor may have recommended a hernia operation. The decision whether or not to have

More information

OPEN TENSION FREE REPAIR OF INGUINAL HERNIAS; THE LICHTENSTEIN TECHNIQUE

OPEN TENSION FREE REPAIR OF INGUINAL HERNIAS; THE LICHTENSTEIN TECHNIQUE C:\251 GNA\preperitoneal hernia repair\lichtenstein-english.doc To be considered for publication in BMC-Surgery OPEN TENSION FREE REPAIR OF INGUINAL HERNIAS; THE LICHTENSTEIN TECHNIQUE George H. Sakorafas,

More information

Prosthetic mesh used for inguinal and ventral hernia repair: normal appearance and complications in ultrasound and CT

Prosthetic mesh used for inguinal and ventral hernia repair: normal appearance and complications in ultrasound and CT The British Journal of Radiology, 77 (2004), 261 265 DOI: 10.1259/bjr/63333975 E 2004 The British Institute of Radiology Pictorial review Prosthetic mesh used for inguinal and ventral hernia repair: normal

More information

ULTRASOUND VENOGRAPHY

ULTRASOUND VENOGRAPHY ULTRASOUND VENOGRAPHY SCAN PROTOCOL Linear array transducer for thigh and calf veins 5MHz-9MHz Curvilinear transducer for pelvic and abdominal veins 2MHz-6MHz SCAN PROTOCOL ILIO-FEMORAL SEGMENT Patient

More information

Inguinal Hernia Repair

Inguinal Hernia Repair Inguinal Hernia Repair (Laparascopic Surgery) Department of Surgery www.yeovilhospital.nhs.uk 2 Contents What is an Inguinal Hernia Repair? 5 What is a Laparoscopic Inguinal Hernia Repair? 5 Are there

More information

BERGEN COMMUNITY COLLEGE DIAGNOSTIC MEDICAL SONOGRAPHY PROGRAM Division of Health Professions DMS 213 SYLLABUS

BERGEN COMMUNITY COLLEGE DIAGNOSTIC MEDICAL SONOGRAPHY PROGRAM Division of Health Professions DMS 213 SYLLABUS BERGEN COMMUNITY COLLEGE DIAGNOSTIC MEDICAL SONOGRAPHY PROGRAM Division of Health Professions DMS 213 SYLLABUS Course Title: DMS 213 - Abdominal Sonography 2 2 lec. 3 lab. 3 credits (5 hours) Required

More information

Information leaflet for parents/carers. Inguinal Hernia Repair

Information leaflet for parents/carers. Inguinal Hernia Repair Information leaflet for parents/carers Inguinal Hernia Repair Introduction An inguinal hernia first appears as a bulge or lump in the groin. In boys, this lump is usually caused by a loop of the intestine

More information

Epigastric Hernia Repair

Epigastric Hernia Repair Epigastric Hernia Repair WHAT IS EPIGASTRIC HERNIA REPAIR? 2 WHAT CAUSES IT? 2 WHAT DOES TREATMENT/MANAGEMENT INVOLVE? 2 WHAT WOULD HAPPEN IF THE HERNIA WAS NOT TREATED? 3 EPIGASTRIC HERNIA REPAIR 3 WHAT

More information

Interim Clinical Commissioning Insert heading depending. cover options once

Interim Clinical Commissioning Insert heading depending. cover options once Interim Clinical Commissioning Insert heading depending Insert Policy: Insert heading Abdominal depending Wall Hernia on line on on Management line length; length; please please delete delete on line line

More information

Surgery Symposium 2012

Surgery Symposium 2012 Surgery Symposium 2012 The Complex Ventral Hernia: How to patch a Hole When It s Bigger Than Your Finger April 28, 2012 Travis Littman MD Winnie Henderson MD PhD Northwest Surgical Specialists, LLP No

More information

Hernia- Open Inguinal Hernia Repair PROCEDURAL CONSENT FORM. A. Interpreter / cultural needs. B. Condition and treatment

Hernia- Open Inguinal Hernia Repair PROCEDURAL CONSENT FORM. A. Interpreter / cultural needs. B. Condition and treatment DO NOT WRITE IN THIS BINDING MARGIN v5.00-04/2011 SW9317 Hernia- Open Inguinal Hernia Repair Facility: A. Interpreter / cultural needs An Interpreter Service is required? Yes No If Yes, is a qualified

More information

Laparoscopic Surgery for Inguinal Hernia Repair

Laparoscopic Surgery for Inguinal Hernia Repair Laparoscopic Surgery for Inguinal Hernia Repair What is an Inguinal Hernia Repair? 2 What is a Laparoscopic Inguinal Hernia Repair? 2 Are there any alternatives to Laparoscopic Hernia Repair? 3 Am I a

More information

Laparoscopic Anatomy of the Pelvis

Laparoscopic Anatomy of the Pelvis 2 Laparoscopic Anatomy of the Pelvis Intra-Abdominal Anatomy of the Male Pelvic Region Bladder Medial Umbilical Ligaments Lateral Umbilical Ligaments Spermatic Cords Iliac Vessels Ureters Seminal Vesicular

More information

when they are very inexperienced surgeons. Therefore, students are taught many techniques that are

when they are very inexperienced surgeons. Therefore, students are taught many techniques that are EFFICIENT DOG AND CAT SPAY/NEUTER TECHNIQUES Philip A. Bushby, DVM, MS, DACVS Marcia Lane Endowed Professor of Humane Ethics and Animal Welfare Mississippi State University, College of Veterinary Medicine

More information

SURGICAL PHYSIOLOGY OF INGUINAL HERNIA REPAIR (A STUDY OF 200 CASES) M.S. (Gen.Surg.) 1. Poona Hospital & Research Centre, Pune.

SURGICAL PHYSIOLOGY OF INGUINAL HERNIA REPAIR (A STUDY OF 200 CASES) M.S. (Gen.Surg.) 1. Poona Hospital & Research Centre, Pune. 1 SURGICAL PHYSIOLOGY OF INGUINAL HERNIA REPAIR (A STUDY OF 200 CASES) Dr. Mohan P.Desarda M.S. (Gen.Surg.) ATTACHMENTS 1. Poona Hospital & Research Centre, Pune. 2. Kamala Nehru General Hospital, Pune.

More information

PARIETEX MESH CLINICAL STUDIES COMPENDIUM

PARIETEX MESH CLINICAL STUDIES COMPENDIUM PARIETEX MESH CLINICAL STUDIES COMPENDIUM CLINICAL ARTICLES REVIEWED New Developments in Hernia Repair 1 Comparison of Tissue Integration Between Polyester and Polypropylene Prostheses in the Preperitoneal

More information

Comparison of Desarda versus Modified Bassini inguinal Hernia Repair: A Randomized controlled trial.

Comparison of Desarda versus Modified Bassini inguinal Hernia Repair: A Randomized controlled trial. Comparison of Desarda versus Modified Bassini inguinal Hernia Repair: A Randomized controlled trial. S M Situma, S. Kaggwa, N.M. Masiira, S.K. Mutumba. Department of Surgery, Mulago Hospital, Kampala -

More information

A Sports Physician s Perspective

A Sports Physician s Perspective Groin Pain Non-Surgical Treatments & Rehabilitation A Sports Physician s Perspective A Dr Ralph Rogers MD PhD MBA FACN FECSS FACSM FFSEM Sports & Musculoskeletal Physician London Orthopaedic Clinic 30

More information

The Sports Hernia. Russell Steves M.Ed, ATC, PT Princeton University

The Sports Hernia. Russell Steves M.Ed, ATC, PT Princeton University The Sports Hernia Russell Steves M.Ed, ATC, PT Princeton University Why Should I Care? You may run into it An athlete with groin pain not getting better You may read about it An athlete may read about

More information

A comparative study of inguinal hernia repair by Shouldice method vs other methods

A comparative study of inguinal hernia repair by Shouldice method vs other methods Gohel J, Naik N, Parmar H, Solanki B. A comparative study of inguinal hernia by Shouldice method vs other Original Research Article A comparative study of inguinal hernia by Shouldice method vs other methods

More information

Take Home Message What at the basic tenets of AWR? What are the basic technical aspects of each approach? Limitations and benefits of each approach.

Take Home Message What at the basic tenets of AWR? What are the basic technical aspects of each approach? Limitations and benefits of each approach. AWR: Endoscopic CST, Ramirez CST, Stoppa, Posterior CST: A Decision Analysis Michael J. Rosen MD, FACS Professor of Surgery Director, Cleveland Clinic Comprehensive Hernia Center Cleveland Clinic Foundation

More information

Diagnosis of Inguinal Region Hernias with Axial CT: The Lateral Crescent Sign and Other Key Findings 1

Diagnosis of Inguinal Region Hernias with Axial CT: The Lateral Crescent Sign and Other Key Findings 1 Note: This copy is for your personal non-commercial use only. To order presentation-ready copies for distribution to your colleagues or clients, contact us at www.rsna.org/rsnarights. GASTROINTESTINAL

More information

Reimbursement Guide Hernia Repair

Reimbursement Guide Hernia Repair Reimbursement Guide CPT Codes CPT Codes Description Component Separation Technique 15734 Muscle, myocutaneous, or fasciocutaneous flap; trunk (Note: Report 15734 twice if procedure is bilateral) 11008

More information