Endoscopic surgery in treatment of inguinal hernia was first used in 1884 and published as perfect technique in 1887. Nowadays, this technique has been applied widely in developed countries, especially in Euro and United State. There are three common graft techniques through endoscopy: Graft in peritoneal, graft through abdominal in front of peritoneal, graft outside peritoneal. Inguinal hernia can be treated by both standard open surgery technique and modern endoscopic surgery. Endoscopic surgery in treatment of inguinal hernia is safe and effective for about 95 patients with inguinal hernia. This technique has been applied in Vietnam in recent years, but it has not been published widely.
Hernia, Inguinal ; Surgery ; Therapeutics ; Endoscopy

Female ; Hernia, Inguinal ; etiology ; pathology ; surgery ; Humans ; Male ; Risk Factors

OBJECTIVETo evaluate the surgical strategy for laparoscopic approach in recurrent inguinal hernia repair.

METHODSBetween January 2001 and December 2011, the clinical data of 213 patients with 225 recurrent inguinal hernias underwent laparoscopic repair were retrospectively analyzed. There were 202 male and 11 female patients and their average age were (67 ± 14) years old (range 22-97 years old). The surgical methods included laparoscopic transabdominal preperitoneal hernia repair (TAPP, n = 174), total extraperitoneal herniorrhaphy (TEP, n = 41) and intraperitoneal onlay mesh (IPOM, n = 10). The follow-up period ranged from 15 to 60 months (median 42 months). No patient lost to follow-up during the investigation.

RESULTSThe 48 TAPP and 26 TEP were applied to 77 (32.9%) recurrent hernias after conventional suture repair; 23 TAPP and 15 TEP were utilized to 38 (16.9%) recurrent hernias after Lichtenstein repair; 90 TAPP and 1 IPOM were employed for 91 (40.4%) recurrent hernias after Patch and Plug repair; and the other 22 (9.8%) recurrent hernias after preperitoneal repair were repaired by using 13 TAPP and 9 IPOM techniques. No conversion to open surgery was observed. The average operative time was (39 ± 14) minutes (range 15-90 minutes). No patients required analgesia postoperatively. The postoperative average VAS score was 2.4 ± 1.1 (range 1.2-6.4). The average hospital stay was (1.7 ± 1.5) days (range 1-9 days), and the patients returned to unrestricted activities in 2 weeks was 99.6% (212 cases). No recurrence was observed during the follow-up. The accumulative postoperative complications rates was 11.1% (25 cases), with 1 severe complication (surgical intervention was needed) as intraabdominal infection (0.4%), as well as other 24 complications including 15 cases of seroma (6.7%), 5 cases of urinary retention (2.2%), 3 cases with transient paresthesia (1.3%) and 1 case with paralytic ileus (0.4%).

CONCLUSIONSTAPP and TEP are both feasible and efficacious techniques to treat recurrent hernias after suture repair and Lichtenstein repair, while the choice depends on surgeons' experience. Most recurrent hernias after Patch and Plug repair could be treated successfully by TAPP but TEP technique is not encouraged. For recurrences after preperitoneal repair, the TAPP repair should be recommended as first choice, while IPOM is a good technique to cope with the cases which TAPP failed.

Child ; Hernia, Inguinal ; surgery ; Herniorrhaphy ; methods ; Humans ; Laparoscopy ; methods

Repair of inguinal hernia is widely regarded as a simple procedure, requiring no great surgical skill. Published recurrence rates are high, indicating that there is need for improvement in technique. This paper gives details of a satisfactory method which uses local anaesthesia.
Anesthesia, Local ; Hernia, Inguinal - surgery ; Humans ; Surgical Procedures, Operative - methods

Inguinal hernia refers to an extraperitoneal hernia occurring in the inguinal region. The etiology of inguinal hernia is not completely clear, but is related to gender, age and family history. According to the anatomy of hernia, there are indirect hernia, direct hernia, femoral hernia, composite hernia and peripheral femoral hernia. According to the content of the hernia sac, it is divided into reducible hernia, irreducible hernia, incarcerated hernia and strangulated hernia. There are also several special types of hernia. Typical inguinal hernia can be diagnosed by medical history, symptoms and physical examination. If the diagnosis is unclear or difficult, the imaging examination can assist the establishment of diagnosis. Only through surgery, inguinal hernia in adult patients could heal. The following requirements should be fulfilled: (1)The surgeons need to acquire accreditation of medical residency and should have corresponding surgical training; (2)The qualification of laparoscopic surgeons require the completion of basic laparoscopic training and hernia fellowship training as well as passing relative examinations; (3)Training of hernia and abdominal wall surgeons should be completed in centers with corresponding qualifications; (4)Preoperative education should be provided to patients and/or their families, emphasizing the communication with patients before surgery and indicating the operation principle and measures, whether mesh should be used, and informed consent should be given. Hernia repair materials are mainly non-absorbable inert mesh. Surgery could be divided into two types: open and laparoscopic surgery, including tissue suture repair, repair with materials, total extraperitoneal repair (TEP) and trans-abdominal preperitoneal repair(TAPP), etc. Combined with the clinical practice in China,we completed the "Guideline for Diagnosis and Treatment of Adult Groin Hernia (2018 edition)" on the basis of the previous edition of the guideline. The relevant medical institutions and peers in China are requested to carry out this guideline according to actual clinical reference.
Adult ; China ; Groin ; Hernia, Femoral ; Hernia, Inguinal ; surgery ; Herniorrhaphy ; Humans ; Laparoscopy ; Surgical Mesh

Abdominal Neoplasms ; diagnosis ; surgery ; Aged ; Diagnosis, Differential ; Hernia, Inguinal ; diagnosis ; Humans ; Inguinal Canal ; pathology ; Lymphangioma ; diagnosis ; surgery ; Male ; Treatment Outcome

Hernia, Inguinal/surgery* ; Humans ; Mesothelioma/surgery* ; Mesothelioma, Malignant ; Peritoneal Neoplasms/surgery* ; Peritoneum

We reported a case of irreducible indirect inguinal hernia caused by sigmoid colon cancer entering the right groin.The patient complained about a right groin mass for more than 60 years with progressive enlargement for 3 years and pain for half a month.Abdominal CT examination at admission showed rectum and sigmoid colon hernia in the right inguinal area and thickening of sigmoid colon wall.Electronic colonoscopy and pathological diagnosis showed sigmoid colon cancer.Therefore,the result of preliminary diagnosis was irreducible indirect inguinal hernia caused by sigmoid colon cancer entering the right groin.We converted laparoscopic exploration to laparotomy followed by radical sigmoidectomy and employed end-to-end anastomosis of descending colon and rectum in combination with repair of right inguinal hernia.The patient recovered well after operation and was discharged.
Colon, Sigmoid/surgery* ; Groin ; Hernia, Inguinal/surgery* ; Humans ; Laparoscopy ; Sigmoid Neoplasms/surgery*

Appendicitis ; Appendix ; pathology ; surgery ; Hernia, Inguinal ; diagnosis ; surgery ; Humans ; Male ; Middle Aged