Surg Clin North Am. Dec;78(6) Inguinal hernia repair. The Nyhus posterior preperitoneal operation. Patiño JF(1), García-Herreros LG, Zundel N. The Nyhus Posterior Preperitoneal Operation The repair of inguinofemoral hernias constitutes the most widely performed general surgical procedure. Adapted with permission from Nyhus LM, Klein MS, Rogers FB. Inguinal hernia. Curr Probl Surg ;

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Instead, they are acquired by the development of tissue deficiencies of the transversus abdominis muscle, which makes up the floor of the inguinal canal.

The reported recurrence rates for surgically treated hernias vary widely, depending on the length and diligence ynhus the follow-up period. Lastly, there are bonus chapters that discuss ventral incisional, pediatric, and diaphragmatic hernias.

Another section is devoted exclusively to the options of hernia repair. An understanding of the innervation of the inguinal region is important, because injury to the nerves in this area may cause significant problems.

This is a wonderful source of information for the young surgeon in training, as it makes one of the most complex areas of the body easy to grasp and understand.

Most inguinal hernia repairs can be performed safely, accurately and cost-effectively herias local anesthesia and an open anterior approach. Sonography may be useful in diagnosing inguinal hernias in patients who report symptoms but do not have a palpable defect. If one system is universally used to classify hernias, surgeons will be able to perform individualized procedures for specific anatomic defects based on sound outcome data.


Mesh is used to reconstruct the inguinal canal. Studies conducted at nonspecialty centers probably provide a more accurate view of hernia repair techniques and results. The male-to-female ratio is 9: Average of 3 years, with a range of 1 to 5 years. Average of 4 years range: In contrast, tension-free repair using mesh, as well as other types of hernia repair, may be comfortably and safely nyuus with patients receiving only local anesthesia.

Excellent results have been achieved with this approach, and reported recurrence rates have been less than 1 percent.

Minimal tension is used to bring tissues together. Women may be predisposed to femoral herniation due to weakness of the pelvic floor musculature from previous childbirth Figure 4. Get free access to newly published articles Create a personal account or sign in to: Type II—indirect inguinal hermias.

The approach is best determined by local expertise.

Inguinal hernia repair. The Nyhus posterior preperitoneal operation.

Laparoscopic or open inguinal herniorrhaphy? The Cooper ligament repair. There are 72 national and international contributors covering a variety of old and new topics in pages. Dissection then continues behind and deep to the entire inguinal region. Almost all groin hernias should be surgically repaired. Performance of the laparoscopic TAPP herniws also exposes patients to potential intra-abdominal injury and late adhesion formation. General anesthesia provides the most comfort, but it has the highest risk.

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Mechanisms of hernia recurrence after preperitoneal mesh repair. Global anatomy of the pelvis and inguinal trigone. Specialty centers continue to jyhus very low complication and recurrence rates in large series of patients.

Surgical Options in the Management of Groin Hernias

A broad portion of mesh is stapled to span both hernia defects. Each is also featured for pros and cons i. Email Alerts Don’t miss a single issue.

The hernial sac can then migrate down along the femoral vessels into the anterior thigh. However, extensive accumulated experience with the hernia mesh has begun to nyhuw many of these concerns, and tension-free repair continues to gain popularity. Thus, these hernias protrude directly through a defect in the inguinal canal floor, rather than indirectly following the potential space of the processus vaginalis and the path of the spermatic cord.

Nyhus and Condon’s Hernia | JAMA Surgery | JAMA Network

An additional 20 percent of recurrences may not present for 15 to 25 years. Privacy Policy Terms of Use. Note hernizs lush innervation of this region.

Copyright American Medical Association. Posterior iliopubic tract repair.