Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “hernia”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 91 records · Page 5Linked to original sources
PubMed2004

Extraperitoneal laparoscopic approach to Spigelian hernia combined with groin hernias.

Spigelian hernia is a rare form of abdominal wall hernia. It occurs when peritoneum with or without organs or preperitoneal fat exists through a defect in the Spigelian fascia. A 63 year old male patient complaint of inguinal hernias and Spigelian hernia treated with laparoscopic approach that has been not previously reported in the literature. The use of the laparoscope has simplified the diagnosis, clarified its localization, and facilitated the subsequent repair of these hernias.

Comorbidity↗
PubMed1997

Incisional hernia recurrence following "vest-over-pants" or vertical Mayo repair of primary hernias of the midline.

A series of 68 primary midline incisional hernias with a vertical Mayo repair was evaluated retrospectively. Patients without documented hernia recurrence following this repair were invited for physical examination. Life-table methods were used for statistical analysis. The 1-, 3-, 5-, and 10-year cumulative recurrence rates were 35%, 46%, 48%, and 54%, respectively. Also, generally accepted risk factors were studied. Multivariate analysis identified the size of the hernia (p = 0.02) and the use of steroids (p = 0.04) as the most important independent risk factors of first time recurrent incisional hernia. Considering the high recurrence rates found, the results of this study strongly suggest that the vest-over-pants repair should no longer be used for closure of midline incisional hernias.

Adult↗
PubMed2003

A new tension-free technique for the repair of umbilical hernia, using the Prolene Hernia System--early results from 48 cases.

Tension-free repair using the Prolene Hernia System (PHS) has been widely adopted for inguinal hernias with excellent results. In our department, a new technique for umbilical hernia repair, using the PHS, has been developed. Between 2000 and 2002, 48 patients underwent tension-free umbilical hernia repair, using the PHS. There were 20 male and 28 female patients, with a mean age of 54 years. The preperitoneal space was dissected to accumulate the underlay patch of the PHS. The onlay patch was placed on the anterior rectus sheath and the connector in the umbilical ring. The median operating time was 35 min (range, 28-40). Postoperative pain was minimal, and there were no complications associated with the mesh, except a seroma, which required needle aspiration. There were no recurrences after a median follow-up of 13 months (1-24). Our early results indicate that the described tension-free technique could become the standard treatment for umbilical hernia repair, but long-term results are required to establish the efficacy of the procedure.

Adult↗
PubMed2005

Closer to an ideal solution for inguinal hernia repair: comparison between general surgeons and hernia specialists.

BACKGROUND: It is accepted a priori that specialists of hernia surgery have better results than general surgeons who use the same or different techniques as part of their complete surgical repertoire. METHODS: Results of general surgeons trained in the technique of hernia repair using a bilayer connected mesh device (BCMD) was compared to results of specialists and other general surgeons who used other techniques. RESULTS: One report from hernia specialists and three additional reports from trained general surgeons showed similar results using a BCMD. These results were better than results of all other mesh repairs. DISCUSSION: This study shows the value of surgeon-training as well as the value in the design of a particular mesh device for hernia repair. The three components of this device offer three separate, yet connected, barriers to the formation of a recurrent hernia. CONCLUSION: General surgeons trained to use a bilayer mesh device repeatedly duplicated the results of specialists who used it.

General Surgery↗
PubMed1981

Strangulated hernia of the foramen of Morgagni: introducing a principle for the reduction of obstructed intraabdominal hernias.

Comments are made on diaphragmatic hernias in general, and hernia of the foramen of Morgagni in particular. A case history is recorded of strangulation of such a hernia in a man of 76 years. Reduction of the entrapped colon was effected by intraluminal suction-decompression across the neck of the hernia. Search of the literature suggests that this principle is an innovation, and that it is an important manoeuvre for the management of any obstructed intraabdominal hernia where there is technical difficulty in its reduction.

Aged↗
PubMed2003

A prospective study of 1000 hernias: results of the Plymouth Hernia Service.

BACKGROUND: A hernia service within a general hospital was prospectively evaluated to establish whether evidence-based protocols could deliver results comparable to those reported from specialist hernia clinics. METHODS: Protocols were devised according to established models. With the support of a nurse specialist, 1015 patients with inguinal hernia were treated. Quality-of-life analysis was undertaken using the Short Form 36. RESULTS: Patients ranged in age from 16-98 years (median, 56 years). Ambulatory day-case surgery was achieved in 820 patients (81%), with local anaesthesia in 891 (88%). Wound infection occurred in 10 patients (0.98%). Wound haematoma requiring surgical intervention occurred in three patients. Two patients formed wound seromas that settled spontaneously. One patient developed ischaemic orchitis resulting in testicular atrophy. At 5 days after operation, 91% of patients had returned to normal activity. At 1 year, 7 patients (0.7%) had pain sufficient to limit normal activity or employment. There were 8 recurrences (0.78%) at a median follow-up of 2.5 years. Quality-of-life was enhanced at 1 year postoperatively. CONCLUSION: A protocol-driven hernia service within a general hospital can provide patient outcomes comparable to specialist hernia clinics.

Adolescent↗
PubMed1997

A patient with a traumatic right diaphragmatic hernia occurring 4 years after sustaining injury--statistical observations of a delayed diaphragmatic hernia caused by uncomplicated injury in Japan.

We describe our experience with a patient in whom a traumatic right diaphragmatic hernia developed 4 years after sustaining injury and review cases of delayed diaphragmatic injury reported in Japan. The patient was a 28-year-old man who sustained a severe contusion of the right epigastric region and fractured a right rib in a traffic accident in September 1992. In August 1996, the patient presented with shortness of breath on effort or after meals. A chest roentgenogram revealed intestinal gas in the right side of the thoracic cavity. A right diaphragmatic hernia was diagnosed on the basis of a gastrointestinal series, and the patient was operated on. The hernial orifice extended anteriorly from the central tendon in an 11:00 direction and measured 11 x 6 cm. The small intestine, right side of the colon, and liver were herniated. A total of 297 cases of blunt traumatic diaphragmatic hernia were reported in Japan between 1981 and 1996, including 47 cases (left side, 32 cases; right side, 15 cases) of delayed diaphragmatic hernia, defined as occurring one month or more after injury. Diaphragmatic hernia should be considered as a possible diagnosis in patients with abnormal shadows in the thoracic region who have recently sustained injury or who have a past history of injury.

Abdominal Injuries↗
PubMed1992

Anatomical laparoscopic hernia repair of direct or indirect inguinal hernias using the transversalis fascia and iliopubic tract.

Fourteen patients with symptomatic inguinal hernias underwent anatomic repair, which approximates the transversalis muscle and fascia to the iliopubic tract. Polyproprolene mesh was used to obliterate the canal space formerly occupied by the hernia sac. Nine patients were operated on for a direct inguinal hernia, four for an indirect hernia, and one recurrent direct hernia. Two patients required the laparoscopic approach to abandoned in favor of an open method. The remaining 12 patients underwent laparoscopic repair and were discharged within 23 h of the procedure.

Adult↗
PubMedDate not supplied

[Ishiadic hernia (sciatic hernia)].

The sciatic hernia is a protrusion of the peritoneal sac and its contents through the great or small sciatic foramen. This kind of hernia is an extremely rare. The authors present patient with ischiadic hernia and its operative repair. The preoperative diagnosis was a tumour (cyst) localized intraglutealy, but during operation sciatic hernia was found. Hernia was operatively removed making an oblique incision over the palpable mass, splitting the gluteous maximus, and exposing and opening the hernial sac, avoiding nerve and vascular injury by careful dissection of the sac. Then the sac was ligated and excised. Closing of the musculature defect was made with interrupted sutures of 000-Dexon, aproximating the gluteus maximus and medius muscles to the musculus piriformis. The authors consider that transgluteal approach has priority to transabdominal approach.

Aged↗
PubMed1984

[Inguinal hernia in women: a complication of pregnancy or labor. Apropos of 160 cases of surgically treated hernias].

The authors undertook a computerised retrospective study of 10 years of hernia surgery. Analysis of the specific characteristics of hernias in women provided numerical data concerning a number of classical data and in particular revealed the role of multiple gestation (more than 3 pregnancies) in the aetiology of inguinal hernias. Results of different surgical techniques are reported: herniorrhaphy procedures (e.g. the MacVay operation which should perhaps be abandoned to give way to the Shouldice procedure) retain a wide role in women. The Dacron mesh prosthesis, with an additional risk of infection of 0.5 to 3.7% offers long term reliability (98.5% cure rate) which cannot be hoped for with any herniorrhaphy procedure when repairing the most difficult hernias. The authors suggest that gynaecologists and obstetricians should continue the study or physiopathological mechanisms causing hernias since they alone would be capable of undertaking such a prospective study.

Adolescent↗
PubMedDate not supplied

[Inguinal hernia in adults. Subperitoneal prosthesis under celioscopic control (370 operated sides in 320 patients with 411 hernias)].

The authors present their technique of groin hernias repair by putting of a very tall (15 X 15 cm for unilateral hernias, or 30 X 15 cm for bilateral hernias). Polypropylene prosthesis in subperitoneal space by laparoscopic access. From may 1991 to june 1993, 320 patients were operated on 370 sides (50 bilateral hernias) with a total of 411 hernias. The first results are analysed: there was in particular no conversion and infection. Recurrences were studied only on the patients operated since at least one year: There were 1 recurrence (0.6%) on 163 sides operated in 141 patients with a mean average follow up of 17 months. There were 2 occlusions (on 370 sides operated), by incarcerated small bowel in the preperitoneal space after partial failed of the peritoneal suture. The first patient was reoperated on at the fifteenth postoperative day (chronic occlusion) by laparotomy. The second patient was reoperated on at the fifth postoperative day by laparoscopy which permit to reduce the small bowel in the abdominal cavity and closing the peritoneum with a new suture. It should be observed that 74 patients (23%) were operated on epidural anesthesia.

Adult↗
PubMed1998

[The so-called Spigelian hernia--a rare lateral hernia of the abdominal wall].

A patient with Spigelian hernia is presented and the main pathological and clinical features are discussed. Its true incidence is probably greater than the small number of patients reported in the literature due to failure to recognize the clinical picture. A hernia through a defect in the Spigelian fascia (aponeurosis of the transverse muscle of the abdomen) is called Spigelian hernia. The semilunar (Spigelian) line is defined as the line forming the transition from muscle to aponeurosis in the transverse muscle of the abdominal wall. It is a lateral convey line between the costal arch and the pubic tubercle. The part of the aponeurosis that lies between this semilunar line and the lateral edge of the rectus muscle is called the "Spigelian fascia" (correct: Spigelian aponeurosis). The hernia is located intramurally because the hernia is covered by the aponeurosis of the external oblique aponeurosis, so that both, the hernial sac and the orifice, can often not be detected by palpation. Clinical symptoms are not characteristic but most patients have a distinct tender point above the hernial orifice.

Abdominal Muscles↗
PubMed1980

Hiatus hernia: a complication of postero-lateral diaphragmatic herniation (Bochdalek hernia) in infants.

During the six years from January 1973 to Februrary 1979, 23 infants with postero-lateral diaphragmatic (Bochdalek) hernias have been treated in the Paediatric Surgical Unit of the General Infirmary at Leeds. Surgical repair was performed in all cases. Ten patients died. Severe vomiting occurred in seven (54%) of the 13 survivors. Barium meal demonstrated large hiatus hernias in four (31%) of the 13 survivors. This previously unreported complication of Bochdalek hernia repair should be consideredin all patients with vomiting following surgical repair of a Bochdalek hernia.

Diaphragm↗
PubMed2006

Prenatal intervention for isolated congenital diaphragmatic hernia.

PURPOSE OF REVIEW: We aim to review the recent literature regarding early prenatal prediction of outcome in babies diagnosed with isolated congenital diaphragmatic hernia, as well as results of fetal therapy for this condition. RECENT FINDINGS: Current survival rates in population-based studies are around 55-70%. Highly specialized centers report 80% and more, but discount the hidden mortality, mainly in the antenatal period. Fetuses presenting with liver herniation and a lung-to-head ratio of less than 1.0 measured in midgestation have a poor prognosis. Other volumetric techniques are being evaluated for use in midtrimester. Recently, a randomized trial failed to show benefit from prenatal therapy, but lacked power to document the potential advantage of prenatal therapy in severe cases. We proposed percutaneous fetal endoluminal tracheal occlusion with a balloon at 26-28 weeks through a 3.3 mm incision. In severe cases, fetal endoluminal tracheal occlusion increased lung size as well as survival, with an early (7 day) survival, late neonatal (28 day) survival and survival at discharge of 75, 58 and 50%, respectively, comparing favorably with 9% in contemporary controls. Airways can be restored prior to birth improving neonatal survival (83.3% compared with 33.3%). The procedure carries a risk for preterm prelabour rupture of the fetal membranes, although that may decrease with experience. SUMMARY: Fetuses with severe congenital diaphragmatic hernia can be identified in the second trimester. Fetal endoluminal tracheal occlusion can be considered as a minimally invasive fetal therapy, improving outcome in such highly selected cases.

Female↗
PubMed2002

Preperitoneal approach to parastomal hernia with coexistent large incisional hernia.

OBJECTIVE: To assess the outcome of preperitoneal mesh repair of complex incisional herniae incorporating a stoma and large parastomal hernia. METHODS: From 1994 to 1998, symptomatic patients who had repair of combined incisional hernia and parastomal hernia were reviewed. Body mass index, co-morbidity, length of hospital stay, patient satisfaction and outcomes were recorded. RESULTS: Ten patients (seven females and three males), mean age 62 (range 48-80) years underwent primary repair. All had significant comorbidities (ASA grade 3) and mean body mass index was 31.1 (range 20-49). Median hospital stay was 15 (range 8-150) days. Complications were of varying clinical significance (seroma, superficial infection, major respiratory tract infection and stomal necrosis). There were no recurrences after a mean follow up of 54 (range 22-69) months. CONCLUSION: The combination of a parastomal hernia and generalised wound dehiscence is an uncommon but difficult problem. The application of the principles of low-tension mesh repair can provide a satisfactory outcome and low recurrence rate. This must be tempered by recognition of the potential for significant major postoperative complication.

Journal Article↗
PubMed2006

Incisional, epigastric and umbilical hernia repair using the Prolene Hernia System: describing a novel technique.

The Prolene Hernia System (PHS) is already widely in use in the United Kingdom for inguinal hernias. We describe the novel technique of using the three-in-one design of the PHS (Ethicon Endo-Surgery, Bracknell, UK) for repairing incisional, epigastric and umbilical herniae. This is a three-dimensional device and consists of an onlay patch, a tubular connector and an underlay patch. We recommend a four 'corner' suturing of the underlay patch under vision (and then) through the full thickness of abdominal wall layers to ensure a flat underlay mesh. These four sutures flatten out the underlay patch and can be tied or removed with equal effect. The sutures are placed at 3, 6, 9 and 12 o'clock, which simplifies the procedure and ensures that the underlay lays correctly and is corrugation-free and tension-free, thereby providing a two-layer repair for those herniae with a high rate of recurrence.

Hernia, Abdominal↗
PubMed1984

Incidence and estimated need of caesarean section, inguinal hernia repair, and operation for strangulated hernia in rural Africa.

Numbers of caesarean sections, inguinal hernia repairs, and operations for strangulated hernia performed in 1979-81 at 10 rural hospitals in eastern Africa were matched against estimated populations in the respective catchment areas. Annual rates of each operation varied considerably between hospitals, the averages being: for caesarean sections 25 per 100 000 per year; for inguinal hernia repairs 25 per 100 000 per year; and for operations for strangulated hernia four per 100 000 per year. The estimated minimum needs for these operations, based on available data for morbidity were 225, 175, and 30 per 100 000 per year, respectively. Numerous deaths and cases of permanent disability occur in remote rural villages because common conditions requiring urgent surgery are neither prevented nor properly cared for. A balanced improvement of both primary and secondary care in rural Africa is needed.

Africa, Eastern↗
PubMed1997

Abdominal circumference in fetuses with congenital diaphragmatic hernia: correlation with hernia content and pregnancy outcome.

To assess the value of abdominal circumference measurements in the second trimester as a predictor of mortality in fetuses with congenital diaphragmatic hernia, 34 fetuses with this condition who had had second trimester ultrasonographic evaluation were analyzed retrospectively for abdominal circumference measurements, content of the hernia, and pregnancy outcome. The abdominal circumference was below the fifth percentile in nine of the 27 fetuses (33%) with an isolated defect and in five of the seven fetuses (71%) with additional anomalies. In fetuses with isolated congenital diaphragmatic hernia, an abdominal circumference measurement below the fifth percentile was associated with the presence of the liver (P < 0.05) but not of the stomach in the chest. In 19 continuing pregnancies with an isolated defect, all five fetuses with an abdominal circumference below the fifth percentile either died prenatally (n = 1), soon after birth (n = 1), or after surgery (n = 3). In contrast, only six of the 14 fetuses (43%) with an abdominal circumference measurement within the normal range died, either soon after birth (n = 2) or after surgery (n = 4) (P < 0.05). We conclude that an abdominal circumference measurement below the fifth percentile in the second trimester appears to be a good predictor of a poor prognosis in fetuses with congenital diaphragmatic hernia.

Abdomen↗