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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Nyhus and Condon’s Hernia

Hernia recurrence following inguinal herniorrhaphy is usually caused by the breakdown of a repair performed with tension along the fascial suture lines. In most reports, the recurrence rate varies from 5 to 8 percent for indirect hernias and is slightly higher for direct hernias. Diagnosis and treatment of genitofemoral and ilioinguinal neuralgia. This advantage appears to be most notable in patients who do heavy manual labor.

Continue reading from January 1, Previous: Average nyhuw 3 years, with a range of 1 to 5 years. With very large defects or with fascia of marginal quality, the tension of the sutures can lead to recurrence. Recurrent inguinal hernia treated by classical hernioplasty. Read the full article.

Nyhus and Condon’s Hernia, 5th Edition

A clear understanding of the epidemiology and anatomy of inguinal hernias provides a solid foundation for timely diagnosis and care. The approach is best determined by local expertise. Group 1 hernia repairs Bassini, McVay and Shouldice techniques involve opening the external oblique aponeurosis and freeing the spermatic cord. The hernia sac passes directly through Hesselbach’s triangle nygus may disrupt the floor of the inguinal canal.

A femoral hernia can occur as a result of elevated intra-abdominal pressure. The advantages of local anesthesia include the very short recovery time and the ability to test the repair intraoperatively with a Valsalva maneuver. Create a free personal account to access your subscriptions, sign up for alerts, and more. This approach was abandoned because of the potential for small-bowel obstruction and fistulae development caused by the exposure of bowel to mesh.


Surgical consultation is usually warranted if the parent or other caregiver reports that the child has had a groin bulge. Patients with ascites generally should not undergo elective herniorrhaphy until their ascites is controlled.

Laparoscopic herniorrhaphy is becoming a more common procedure. An indirect hernia is generally believed to have a congenital component.

Inguinal hernia repair. The Nyhus posterior preperitoneal operation.

Choose a single article, issue, or full-access subscription. While these syndromes are often self-limited, surgery has been necessary to remove the staples that caused the neuralgia. Reprints are not available from the authors. This approach is well suited for outpatient herniorrhaphy performed with the patient receiving local anesthesia.

The laparoscopic approach, similar to the open posterior approach, allows hernia repair to be performed in a previously untouched space. Iliopubic tract repair of inguinal and femoral hernia.

Compared with other types of hernia repair, laparoscopic herniorrhaphy is significantly more expensive. The disadvantages of spinal anesthesia include the time required for the anesthetic to be placed and the possibility of incomplete sensory blockade.

The techniques in the open anterior repair group differ somewhat in their approach to reconstruction, but they all use permanent sutures to approximate the surrounding fascia and repair the floor of the inguinal canal. Nerve entrapment is perhaps hernizs most significant complication of inguinal herniorrhaphy. 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.


These procedures have not provided pain relief in hernia patients. It is the first edition not edited by the original authors, Nyhus and Condon. A study of patients treated with extraperitoneal endoscopic laparoscopic herniorrhaphy.

Transabdominal preperitoneal laparoscopic repair. When the potential complications of incarceration and strangulation are weighed hrrnias the minimal risks of hernia repair particularly when local anesthesia is usednyuhs early repair of groin hernias is clearly justified. Of particular interest are one of the initial chapters on why human beings develop groin hernias, by Read, and the appendices, which deal with human rights, biotechnical designs, and data recording.

This book is in nyuus print and reflects recent advances in a field significantly affected by research, the use of prostheses, and minimally invasive surgery. Immediate access to this article. Almost all groin hernias should be surgically repaired. Patients with such injuries present with pain in the groin and thigh.

Average of 24 months range: Dissection then hernais behind and deep to the entire inguinal region. The development of femoral herniation is not well understood. While the TAPP approach is a straightforward laparoscopic procedure, it requires entrance into the peritoneal cavity for dissection. Surgical repair is usually advised because of the danger of incarceration and strangulation, particularly with femoral hernias.