Surgery & Perioperative/GI / abdominal wall

Hernia repair

also: inguinal hernia repair · herniorrhaphy · mesh repair

Overview

Surgical repair of an abdominal-wall hernia — urgent if strangulated or obstructed.

Mechanism

Reduction of contents + repair of the defect, usually with mesh (tension-free). Strangulation (compromised blood supply) is a surgical emergency to prevent bowel necrosis.

Indications

Symptomatic hernia
EMERGENCY: strangulation/obstruction (tender, irreducible, systemic upset)

The agents

Open mesh (Lichtenstein)

Common for primary inguinal hernia.

Laparoscopic

Bilateral/recurrent hernias.

Adverse effects

Recurrencecommon

Chronic groin pain / nerve injurycommon

Bowel resection if strangulated/necroticserious

Cautions & contraindications

—all

Strangulation overrides comorbidity concerns — emergency.

Choosing it

Groin lump that is tender, irreducible, with overlying erythema and signs of bowel obstruction — a strangulated hernia.

Source: NICE CKS — Hernia