Hernia : the journal of hernias and abdominal wall surgery
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Chronic groin pain is the most common long-term complication after open inguinal hernia repair. Traditional surgical management of the associated neuralgia consists of injection therapy followed by groin exploration, mesh removal, and nerve transection. The resultant hernia defect may be difficult to repair from an anterior approach. We evaluate the outcomes of a combined laparoscopic and open approach for the treatment of chronic groin pain following open inguinal herniorrhaphy. ⋯ A combined laparoscopic and open approach for postherniorrhaphy groin pain results in good to excellent patient satisfaction with no perioperative morbidity. It may be the preferred technique for the definitive management of chronic neuralgia after prior open hernia repair.
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Review Case Reports
Traumatic abdominal wall hernia: delayed presentation in two cases and a review of the literature.
Blunt and penetrating abdominal traumas are an important source of morbidity and mortality in the western world, especially in the young populations. Although most attention during the (primary) diagnostic process is directed toward the detection of internal injuries of the abdomen, blunt or penetrating trauma to the abdomen may result in defects of the abdominal wall. ⋯ Morbidity due to TAWH, however, may be significant. In this article we report the delayed diagnosis of a TAWH in two patients after abdominal wall trauma and present a review of the literature concerning the diagnostic workup and treatment.
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Comparative Study
Incisional hernia--comparison of mesh repair with Cardiff repair: an university hospital experience.
Incisional hernia is a frequent complication of abdominal surgery. Various types of repair are recommended for incisional hernia. Suture and mesh repair are compared in the present study. ⋯ We recommend Cardiff repair for primary and small to medium size incisional hernias. Onlay polypropylene mesh is ideal for tension-free hernia repair, recurrent incisional hernia and hernia defects wider than 10 cm.
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Adult umbilical and paraumbilical hernia repair is associated with a high recurrence rate of 10-30%. Mesh repair has been reported to be associated with low recurrence rates. This study aims to compare sutured repair with prosthetic mesh repair to evaluate recurrence and infection rates. ⋯ Recurrence rates for the suture and mesh repair groups were 11.5 and 0%, respectively (P=0.007). Infection rates for the suture and mesh repair groups were 11.5 and 0%, respectively (P=0.007). Our data suggest that prosthetic mesh repair is ideal for managing primary and recurrent umbilical hernias in both obese and non-obese patients.
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Inguinal hernia sometimes surprises surgeons with its unexpected content. Epiploic appendagitis in hernia sac is a very rare entity. ⋯ Surgical exploration showed a 4-cm mass beneath the external oblique aponeurosis that consisted of a hernia sac containing an inflamed and remarkably swollen appendix epiploica of the sigmoid colon secondary to torsion. The patient recovered after the resection of epiploic appendix and a tension-free hernia repair.