• Inguinal hernia recurrence rate
• Inguinal hernia repair
• Robotic transabdominal preperitoneal repair (r-TAPP)

• Humans
• Hernia, Inguinal/surgery
• Robotic Surgical Procedures/methods
• Robotic Surgical Procedures/statistics & numerical data
• Middle Aged
• Retrospective Studies
• Herniorrhaphy/methods
• Male
• Aged
• Female
• Adult
• Follow-Up Studies
• Treatment Outcome
• Aged, 80 and over
• Time Factors
• Operative Time

• Hernioplasty
• abdominal surgery
• repair techniques

• Hernia, Inguinal/surgery
• Humans
• Herniorrhaphy/methods
• Surgical Mesh
• Recurrence
• Postoperative Complications/etiology
• Treatment Outcome
• Plastic Surgery Procedures/methods

• femoral
• groin
• hernia
• infection
• inguinal
• mesh
• recurrence
• repair
• seroma
• strangulated

• Emergency
• Incarcerated and strangulated groin hernia
• Mesh
• Suture

• Humans
• Aged, 80 and over
• Aged
• Surgical Mesh
• Herniorrhaphy/methods
• Hernia, Inguinal/surgery
• Female
• Male
• Retrospective Studies
• Treatment Outcome
• Suture Techniques
• Length of Stay
• Recurrence
• Groin/surgery
• Postoperative Complications
• Life Expectancy

• 81970455 National Natural Science Foundation of China
• 82170526 National Natural Science Foundation of China

• bowel obstruction
• iliopubic tract division
• incarcerated femoral hernia
• laparoscopic repair
• minimally invasive surgery

• Emergency hernia repair
• Femoral hernia
• Inguinal hernia
• Mesh
• Suture

• Humans
• Groin/surgery
• Hernia, Inguinal/complications
• Herniorrhaphy/adverse effects
• Randomized Controlled Trials as Topic
• Recurrence
• Surgical Mesh
• Surgical Wound Infection/etiology

• adult
• aged
• female
• humans
• male
• middle aged
• groin
• groin/surgery
• hernia, femoral
• hernia, femoral/surgery
• hernia, inguinal
• hernia, inguinal/surgery
• herniorrhaphy
• herniorrhaphy/adverse effects
• herniorrhaphy/methods
• surgical mesh
• surgical mesh/adverse effects
• surgical wound infection

• Male
• Adult
• Humans
• Middle Aged
• Aged
• Female
• Surgical Wound Infection
• Hernia, Inguinal/surgery
• Hernia, Femoral/surgery
• Herniorrhaphy/adverse effects
• Herniorrhaphy/methods
• Surgical Mesh/adverse effects
• Groin/surgery

• Incarcerated
• Inguinal hernia
• Laparoscopic
• Open surgery
• Strangulated

This is a protocol for a Cochrane Review (intervention). The objectives are as follows:

Surgical site infection (SSI) is an inevitable occurrence in bowel perforation with faecal soiled hernia wound(s) especially in retroviral patients. Unfortunately, the increased antibiotics and wound care demands do not prevent delayed healing, increased risk of hernia recurrence, or multiple surgeries to control the infection. The standard open or endo-laparoscopic Mesh repairs are either deferred or avoided with alternative tissue-based hernia repairs after bowel surgery. The reported success of open tissue-based repairs remains mixed. Nylon monofilament that have been used in infected wounds was chosen for the patient in anticipation of wound infection.

A 48-year-old man presented with a 7-days complicated hernia at the emergency unit, Margaret Marquart Catholic Hospital. Clinical examination revealed signs of shock, intestinal obstruction, and peritonism, laboratory investigation was remarkable of anaemia, septicaemia, deranged renal function, and positive retroviral test. He had concurrent right hemicolectomy and nylon darn after optimisation. The outcome we evaluated after surgery included postoperative pain, scrotal collection, anastomotic breakdown, postoperative analgesic use, wounds infection, prolonged hospital stays, recurrence, and the need for a second surgery. Though he developed prolonged deep SSI, he has intact hernia repair after 6-years.

The postoperative critical clinical events presented in this case were unexpected but might have been precipitated by his retroviral status. Thus, a weight loss of over 13 kg within 2 weeks was highly unusual. Furthermore, the positive retroviral status couple with the perforated caecum and soiled peritoneum was the cause of the surgical site infection.

Nylon darning in a retro-positive patient developing prolonged SSI appeared beneficial. It should be considered in patients with anticipated long period wound infection.

•

Surgical site infection is a challenge in hernias with perforated viscus after repair.

• Complicated hernia
• Complicated hernia wound
• Nylon darn repair
• Retroviral infection
• Surgical site infection

• Anatomy
• Groin
• Hernioplasty
• Herniorrhaphy
• History
• Inguinal hernia

• Abdominal
• Hernia
• Incarcerated
• Polypropylene mesh
• Prosthetic repair
• Strangulated

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Female
• Groin/surgery
• Hernia, Inguinal/surgery
• Hernia, Ventral/surgery
• Herniorrhaphy/adverse effects
• Humans
• Male
• Middle Aged
• Prostheses and Implants
• Retrospective Studies
• Surgical Mesh
• Young Adult

• Incarcerated/strangulated inguinal hernia
• Laparoscopy
• Transabdominal preperitoneal repair

• Acute Disease
• China/epidemiology
• Feasibility Studies
• Female
• Hernia, Inguinal/surgery
• Humans
• Laparoscopy/methods
• Length of Stay/statistics & numerical data
• Male
• Middle Aged
• Operative Time
• Postoperative Complications/epidemiology
• Retrospective Studies

Inguinal hernia is probably one of the most common surgical conditions, with strangulation accounting for a good number of acute surgical admissions. It has always been known that direct hernias are less likely to strangulate due to wide hernial defects in comparison to indirect hernia. For that reason, some surgeons do not attempt repair of direct hernias in elderly patients. We present a relatively uncommon case of a 58-year-old gentleman who presented with clinical signs of an incarcerated inguinal hernia; which was found at exploration to be a strangulated direct hernia with small bowel perforation. We believe that direct inguinal hernia should always be included in the differential diagnosis of incarcerated or strangulated groin hernia.

• bowel perforation
• groin
• hernia
• inguinal hernia
• strangulated

Littre's hernia containing Meckel's diverticulum is an extremely rare disease. We report an adult case of two-stage laparoscopic surgery for incarceration of Meckel's diverticulum in an umbilical hernia.

The case involved a 23-year-old, severely obese man with BMI 36.5 kg/m². After experiencing effusion from the umbilicus for 2 months, and was referred from a local dermatologist. We diagnosed an infected urachal remnant, and antibiotic therapy was performed first. Surgery was planned for after the infection disappeared. During follow-up, effusion from the umbilicus took on an intestinal fluid-like character, so we diagnosed small intestinal cutaneous fistula and performed surgery. Under laparoscopy, we found a Meckel's diverticulum incarcerated in an umbilical hernia. The diverticulum was resected first, and the incarceration was released. The umbilicus was infected, so we planned repair of the umbilical hernia in a second surgery. The postoperative course was uneventful and the patient was discharged on postoperative day 5. One month after the initial operation, we confirmed that there were no signs of infection, and performed umbilical hernia repair using the laparoscopic intraperitoneal onlay mesh (IPOM) repair. Postoperative progress was uneventful and he was discharged on postoperative day 4. No recurrence or infection was observed until 8 months postoperatively.

We performed dissection of the diverticulum and umbilical hernia repair for the incarcerated umbilical Littre's hernia under laparoscopy in a severely obese patient. The risk of mesh infection seems to be avoidable using a two-stage surgery, and the risk of recurrence can be reduced using the IPOM repair compared with simple suture closure.

• Intraperitoneal onlay mesh (IPOM)
• Laparoscopic hernia repair
• Littre’s hernia
• Meckel’s diverticulum
• Umbilical hernia

• Abdominal wall hernias
• Irreducible
• Morbidity
• Mortality
• Risk factors

We examined the validity and applicability of the Kugel repair approach for obturator hernias, whereby we placed a Kugel patch through the preperitoneal space after placing a short 5-cm skin incision just medial to the anterior iliac spine and 2 cm cranial to the expected origin of the internal inguinal ring.

We studied patients who underwent surgical Kugel repair for obturator hernias at the Department of General Surgery, Saitama Medical University between 2007 and 2017. We examined the operating time, length of hospital stay, postoperative complications, and mortality rate.

Fifty-eight patients with obturator hernias presented with symptoms of small bowel obstruction. A Kugel approach was used in 53 patients and a midline approach was used in 5 patients with preoperative peritonitis. Of the 53 patients managed using the Kugel approach, 39 did not require intestinal resection; a mesh was used in all these patients. In the remaining 14 patients, intestinal resection was required and performed using the same approach; subsequently, a mesh was used successfully in 6 of these 14 patients. The overall median operating time was 47 min; the corresponding values for procedures with and without intestinal resection were 39 and 68 min, respectively. In terms of postoperative complications, operative mortality was not noted among patients without intestinal perforation; however, superficial surgical site infection developed in 2 patients. Among the 5 patients with preoperative peritonitis who underwent exploratory laparotomy via a midline incision, intestinal perforation was detected during surgery, and all patients required intestinal resection; none of the patients had received a mesh, and 2 patients died after surgery.

The Kugel repair approach was possible even in patients with obturator hernia requiring intestinal resection. However, for patients with perforations, open surgery should be performed after securing the surgical field through a midline incision.

• Kugel repair
• Obturator hernia
• Preperitoneal approach
• Surgical site infection

• bowel resection
• incarcerated groin hernia
• risk factors

• Case-Control Studies
• Emergencies
• Female
• Hernia, Inguinal/complications
• Hernia, Inguinal/surgery
• Herniorrhaphy/adverse effects
• Herniorrhaphy/methods
• Humans
• Intestinal Obstruction/etiology
• Intestinal Obstruction/surgery
• Lymphocytes/metabolism
• Male
• Neutrophils/metabolism
• Retrospective Studies
• Risk Factors

• biological mesh
• emergency
• groin
• hernia
• herniorrhaphy
• incarcerated
• mesh repair

• Groin/surgery
• Hernia, Inguinal/surgery
• Herniorrhaphy/adverse effects
• Humans
• Recurrence
• Retrospective Studies
• Surgical Mesh

• Emergency general surgery
• Emergency hernia repair
• Incarcerated hernia
• Inguinal hernia
• Ventral hernia

This study aimed to explore risk factors of postoperative complications for adult patients with incarcerated groin hernia (IGH).

From January 2010 to December 2017, consecutive patients undergoing emergency hernia repair for IGH in our center were retrospectively reviewed. Postoperative complications, such as surgical site infection, seroma, hernia recurrence and mortality, were investigated, with risk factors for such complications analyzed using univariate and multivariate regressions.

Sixty-four patients were included, with 51 males and 13 females (mean age 65.1, range 25–98 years). Ten patients (15.6%) underwent resection of necrotic bowel and anastomosis. 43 patients (67.2%) received open tension-free herniorrhaphy with polypropylene mesh, whereas the rest (32.8%) received herniorrhaphy without mesh. The overall postoperative complication rate was 40.6% (26/64), with an incisional complication rate of 31.2% (20/64) and an infection rate of 6.2% (4/64). At a median follow-up of 32 months, hernia recurrence and mortality were recorded in five cases each (7.8%). Mesh repair was associated with decreased recurrence rate compared with non-mesh repair (2.3% vs. 19.0%, p = 0.019). Diabetes mellitus (OR 8.611, 95%CI 1.292–57.405; p = 0.026) was an independent risk factor of postoperative complications, together with chronic obstructive pulmonary disease (COPD; OR 14.365, 95%CI 1.652–127.767, p = 0.016), intestinal necrosis (OR 14.260, 95%CI 1.079–188.460, p = 0.044), and general anesthesia (OR 14.543, 95%CI 1.682–125.711, p = 0.015) as risk for incisional complications after surgery.

Diabetes mellitus was an independent risk factor of postoperative complications for IGH, along with COPD, intestinal necrosis and general anesthesia associated with incisional complications. The use of polypropylene mesh did not increase infection or recurrence rate in this cohort.

• Complications
• Herniorrhaphy
• Incarcerated groin hernia
• Risk factors
• Synthetic mesh

• Activities of Daily Living
• Adult
• Hernia, Femoral/surgery
• Hernia, Inguinal/surgery
• Herniorrhaphy/adverse effects
• Herniorrhaphy/methods
• Humans
• Length of Stay
• Operative Time
• Postoperative Complications/etiology
• Randomized Controlled Trials as Topic
• Secondary Prevention
• Surgical Mesh/adverse effects

• autoimmunity
• cancer
• cytokines
• fever
• immunotherapy
• infection
• tumor

• Femoral hernia
• Groin hernia
• Guideline
• Hernia
• Inguinal hernia
• Inguinal hernia repair
• Inguinal hernia treatment
• Laparoscopic inguinal hernia
• Lichtenstein
• Open inguinal hernia
• Practice guideline
• Shouldice
• Standard of care
• TAPP
• TEP

• Adult
• Anesthesia
• Antibiotic Prophylaxis
• Biomedical Research
• Groin/surgery
• Hernia, Femoral/diagnosis
• Hernia, Femoral/surgery
• Hernia, Inguinal/diagnosis
• Hernia, Inguinal/surgery
• Herniorrhaphy/economics
• Herniorrhaphy/education
• Herniorrhaphy/methods
• Herniorrhaphy/standards
• Humans
• Laparoscopy
• Learning Curve
• Surgical Mesh

• Johnson and Johnson
• Bard

• Incarcerated
• inguinal hernia
• prosthetic mesh

• Incarceration
• Inguinal hernia
• Laparoscopic
• Strangulation

AIM: To explore the feasibility of one-stage herniorrhaphy in the treatment of strangulated inguinal hernia with bowel necrosis in elderly patients who could not tolerate a second operation.

METHODS: Clinical data for 44 elderly patients with strangulated inguinal hernia and bowel necrosis were analyzed retrospectively. Age, operative time, postoperative complications and hospitalization, number of cases of inguinal surgical site infection, rate of recurrence, and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHEⅡ) scores were compared between patients who underwent one-stage herniorrhaphy (group A) and those who did not (group B).

RESULTS: The operative time in group A was longer than that in group B (133 min ± 12 min vs 116 min ± 12 min), and the age was older in group A (80 years ± 6 years) than in group B (66 years ± 12 years). Hospitalization duration (18 d ± 3 d vs 17 d ± 3 d), number of cases of postoperative complications (16 vs 12) and inguinal surgical site infection (4 vs 2) did not differ significantly between the two groups. APACHEⅡ score was higher in group A than in group B (10 ± 2 vs 6 ± 2). The rate of recurrence was higher in group A than in group B (0/16 vs 4/18).

CONCLUSION: One-stage herniorrhaphy is feasible in elderly patients with strangulated inguinal hernia with bowel necrosis.

• Elderly patients
• Strangulated inguinal hernia
• Bowel necrosis
• One-stage herniorrhaphy

Hernia is a common problem of the modern world with its incidence more in developing countries. Inguinal hernia is the most common groin hernia repaired worldwide. With advancement in technology operative techniques of repair have also evolved. A PubMed and COCHRANE database search was accomplished in this regard to establish the current status of laparoscopic inguinal hernia repair in view of recent published literature. Published literature support that laparoscopic hernia repair is best suited for recurrent and bilateral inguinal hernia although it may be offered for primary inguinal hernia if expertise is available.

• Laparoscopic hernia repair
• Lichtenstein repair
• Day care surgery
• Open hernia repair
• Inguinal groin hernia

•

Neuroendocrine tumor of the appendix inside an incarcerated Amyand’s hernia is extremely rare.

Amyand’s hernia is a rare type of hernia where the vermiform appendix is within an inguinal hernia sac. Tumors of the appendix are quite uncommon. The coincidence of an Amyand’s hernia with neuroendocrine tumor of the appendix, as in our case, is even more rarely reported.

We report the case of an 81-year-old male who presented with an incarcerated right inguinal hernia. After resuscitation, the clinical diagnosis was confirmed by computed tomography. It showed an incarcerated right inguinal hernia which contained the distal ileum, cecum, thickened appendix, as well as a small amount of fluid. Subsequently, the patient was prepared for emergency surgery. During the operation, the hernia sac was found and opened. The appendix was swollen. Therefore, appendectomy was performed. The inguinal defect was repaired using the Modified Bassini Technique. The patient had an uneventful postoperative recovery and surprisingly the histopathology of the appendix revealed a 1.5 cm well-differentiated low grade neuroendocrine tumor (carcinoid) of the appendix tip.

An incidental finding of neuroendocrine tumor of the appendix in a patient with s hernia is extremely rare. A high index of suspicion is the key to diagnose such a coincidence in order to safely and optimally treat such a condition.

• Amyand
• Carcinoid
• Hernia
• Neuroendocrine

The use of tension-free inguinal hernia repair techniques using commercially available implants is now rather common. However, it is widely accepted that the use of biomaterials should be limited to non-infected surgical fields. As such, most current studies pertain to the application of various implants during the surgical repair of uncomplicated hernias.

To compare the short- and long-term outcomes of incarcerated inguinal hernia repair using the Lichtenstein or Bassini technique.

Between 1997 and 2012, 107 patients were operated on an emergency basis due to the incarceration of inguinal hernias – 105 subjects were included for further analysis in our study.

Postoperative complications were observed in 13 out of the 84 (15.5%) patients subjected to Lichtenstein repair. In 9 of these patients (10.7%), morbidity was associated with the surgical wound. In 2 cases (2.4%), a small inflammatory infiltration was observed and resolved within a few days. Serous fluid accumulation within the wound was observed in 3 patients (3.6%), but the fluid was successfully drained by puncture. Finally, hematoma formed in 4 cases (4.8%). In total, 4 complications (19%) were recorded in the group of 21 patients who were operated on with the Bassini technique. In 3 of these cases (14.3%), the complications were related to suppuration of the surgical wound.

Polypropylene mesh may be safely implanted during the repair of incarcerated hernia and this approach is reflected by satisfactory long-term outcomes.

• Lichtenstein technique
• incarcerated inguinal hernias

• incarcerated inguinal hernias
• mesh repair
• tension-free

• Adult
• Aged
• Emergencies
• Female
• Follow-Up Studies
• Hernia, Inguinal/surgery
• Herniorrhaphy/methods
• Humans
• Male
• Middle Aged
• Time Factors
• Treatment Outcome
• Young Adult

• Adult
• Aged
• Aged, 80 and over
• Biocompatible Materials
• Female
• Hernia, Inguinal/complications
• Hernia, Inguinal/surgery
• Hernia, Obturator/complications
• Hernia, Obturator/surgery
• Humans
• Male
• Middle Aged
• Polypropylenes
• Surgical Mesh/adverse effects
• Young Adult