Pantaloon hernias are a subset of abdominal hernias wherein both indirect and direct components of inguinal hernias are present on one side. Inguinoscrotal hernia of the urinary bladder is a rare condition involved in less than 4% of inguinal hernias and more so if they are part of a direct component of a pantaloon hernia. This is a case of a 65-year-old male who presented a non-reducible right inguinoscrotal mass. Inguinoscrotal herniation of the urinary bladder was preoperatively diagnosed through imaging. Intra-operatively a pantaloon hernia was noted with the herniated urinary bladder as the direct component and omentum as the indirect component. The patient underwent cystourethroscopy, inguinal exploration right, and mesh hernioplasty. The patient had an unremarkable post-operative course and was discharged with improved conditions. Awareness of this clinical condition will aid in the diagnosis, and proper management and prevent post-operative complications.
Herniorrhaphy

Lumbar hernia is a rare surgical entity without a standard method of repair. With advancements in laparoscopic techniques, successful lumbar herniorrhaphy can be achieved by the creation of a completely extraperitoneal working space and secure fixation of a wide posterior mesh. We present a total extraperitoneal laparoendoscopic repair of lumbar hernia, which allowed for minimal invasiveness while providing excellent anatomical identification, easy mobilization of contents and wide secure mesh fixation. A total extraperitoneal method of lumbar hernia repair by laparoscopic approach is feasible and may be an ideal option.
Hernia ; Herniorrhaphy

No abstract available.
Herniorrhaphy* ; Polyethylene Terephthalates*

No abstract available.
Adhesives* ; Cyanoacrylates* ; Herniorrhaphy* ; Polyesters* ; Titanium*

Although single-shot caudal blockade is known as a relatively safe procedure, it is not always without complications. We present a case of accidental bladder puncture that was identified with fluoroscopy by chance after single-shot caudal blockade in a 17-months-old, 12 kg boy who underwent inguinal hernioplasty.
Child ; Fluoroscopy ; Herniorrhaphy ; Humans ; Punctures ; Urinary Bladder

For treatment of pediatric inguinal hernia, we fabricated a device, i.e. so called "filling type pediatric hernia sac", which treats the problem from the abdominal cavity, through the abdominal and is a self-adaptive closer, using synthetic material. The device includes filling rack, self-adaptive umbrella support bar, bottom piece, outside pulling line and device fixing lines. The filling rack is composed of 2 concentric circles of 3.0 cm diameter with peripherally fixed together and can be pulled into the shapes of a ball or an olive. The supporting bar is structured of 3 pieces with 0.5 cm wide, 4.0 cm long, cross-fixed on top of the filling rack. The bottom piece is in a circular structure with a diameter of 3.0 cm, and it is connected to the filling rack bottom. Adjust positioning stay outside the fixed on the top of the device are connected at one end, and the other end free through filling the top frame connected with the bottom slice of central fixation. By using this device, we treated 37 pediatric inguinal hernia cases with 38 side-inguinal hernia successfully. The mean duration of post-operation follow-ups was 14.6 ± 5.89 months, without hernia recurrence, obvious scar and hard sections of inguinal region. This device could provide a convenient, safe and effective plugging technology for children's pediatric hernia.
Child ; Hernia ; therapy ; Herniorrhaphy ; instrumentation ; Humans

Umbilical preservation can be challenging, particularly in complex cases involving simultaneous ventral hernia repair and abdominoplasty. Although the umbilicus serves no functional purpose, removal of the umbilicus can draw unwanted attention to the abdominal area and can cause emotional distress to patients. There are several well documented options for umbilical reconstruction. We present a new umbilical reconstruction technique relevant for such cases. This neoumbilicoplasty allows for preservation of the original umbilicus with relocation and reconstruction using local flaps. The technique is relatively simple and the time needed is minimal. The result is a natural, well positioned umbilicus using the principles of spare part surgery.
Abdominoplasty ; Hernia, Ventral ; Herniorrhaphy ; Humans ; Umbilicus

Remnant urachal cyst is a rare anomaly with an incidence of 1:5,000 and the majority are benign. The treatment of urachal cyst is complete surgical resection, and the cases of laparoscopic surgery for the resection have been reported since 1993. Most of the reports were about transabdominal laparoscopic approach, and it has been revealed that multiple skin incisions and trocar placements on upper abdomen were ineludible. With this condition, we are able to describe an extraperitoneal approach modified from total extraperitoneal herniorrhaphy, and to report a case of successful management of a urachal cyst by total extraperitoneal laparoscopic excision.
Abdomen ; Herniorrhaphy ; Incidence ; Laparoscopy ; Skin ; Surgical Instruments ; Urachal Cyst

Duplication of the vas deferens is a very rare congenital anomaly in which two vasa deferentia coexist within the spermatic cord. Duplication of the vas deferens can be found during herniorrhaphy, vasectomy, and varicocelectomy performed on the spermatic cord or around the spermatic cord. However, it is estimated that the incidence of duplication of the vas deferens is under-reported and under-recognized. Unless anomalies of the vas deferens such as duplication of the vas deferens are recognized by surgeons, it will be difficult to reduce vas deferens injuries and achieve a satisfactory surgical outcome. In addition, care should be taken in cases of duplication of the vas deferens because it can be complicated by non-testicular genitourinary anomalies. We report a case of duplication of the vas deferens discovered during routine varicocelectomy.
Congenital Abnormalities ; Herniorrhaphy ; Incidence ; Spermatic Cord ; Varicocele ; Vas Deferens* ; Vasectomy

BACKGROUND: It has been reported that bilateral pediatric inguinal hernias (PIH) are around 10% and that a late contralateral herniorrhapy is needed in up to 34% of ipsilateral operations. However, clinical prediction of the contralateral patent processus vaginalis (PPV) is difficult. The aims of this study were to measure the mean diameter of the internal inguinal ring (IIR) of the PIH at rest and during straining and to define the diagnostic criterion for positive contralateral PIH (or PPV) by using ultrasonography (USG). METHODS: The diameters of both ipsilateral and contralateral IIRs at rest and during straining were measured preoperatively by USG in 104 consecutive pediatric patients (75 male, 29 female; mean age of 3 years) who had undergone an ipsilateral herniorrhaphy with contralateral exploration from March 1997 to December 1997. Fifty-seven right inguinal hernias (RIH), 43 left inguinal hernias (LIH), and 4 bilateral inguinal hernias were enrolled. The contralateral PPV was defined as a sac greater than 3 mm in diameter and longer than 2 cm in length measured intraoperatively. Statistical analysis was performed by using the t-test and the chi-square test. RESULTS: Contralateral exploration showed positive PPV in 44% of RIH and 47% of LIH (p>0.05). In RIH, the mean diameter of right IIR (RIIR) was wider than that of left IIR (LIIR) (5.02+/-0.27 mm vs 2.94+/-0.12 mm at rest and 7.50+/-0.52 mm vs. 3.82+/-0.23 mm during straining, p<0.01), and the difference in diameters between straining and rest were also significant (2.38+/-0.37 mm in RIIR and 0.76+/-0.14 mm in LIIR, p<0.01). In LIH, the mean diameter of LIIR was wider than that of RIIR (4.59+/-0.27 mm vs. 3.13+/-0.19 mm at rest, 6.82+/-0.43 mm vs. 3.61+/-0.26 mm during straining, p<0.01). The diameter difference between straining and rest of LIIR and RIIR were also significant (2.17+/-0.28 mm in LIIR, 0.60+/-0.12 mm in RIIR, p<0.01). Cases of positive contralateral PPVs in RIH had significantly wider LIIRs than those of negative PPV (3.5+/-0.16 mm vs. 2.5+/-0.14 mm at rest and 4.70+/-0.32 mm vs. 2.97+/-0.20 mm during straining, p<0.01). The difference of diameter between strainingand rest of positive and negative PPVs were significant (1.16+/-0.25 mm and 0.38+/-0.09 mm, respectively, p<0.01). Cases of positive contralateral PPVs in LIH had wider RIIRs than those of negative PPV significantly (3.83+/-0.27 mm vs. 2.52+/-0.18 mm at rest and 4.58+/-0.38 mm vs. 2.68+/-0.19 mm during straining, p<0.01). The diameter difference between straining and rest of positive and negative PPVs was significant (0.93+/-0.21 mm and 0.3+/- 0.09 mm, respectively, p<0.05). CONCLUSION: In most negative PPVs, the diameter of the IIR did not exceed 3.0 mm. Therefore, contralateral IIR with diameters wider than 3.0 mm and diameters of difference more than 1.0 mm between straining and rest, as determined by using USG need to be explored.
Female ; Hernia, Inguinal* ; Herniorrhaphy ; Humans ; Inguinal Canal* ; Male ; Ultrasonography