Hernia Surgery

Hernia Surgery
Title Page
Copyright
Contents
Preface
Editors
Contributors
Synonyms of Anatomical Names
1 Introduction
	1.1 Anatomy of the Anterior Abdominal Wall
		1.1.1 Muscles of the Abdominal Wall
			The Rectus Abdominis Muscle
			The External Oblique Muscle
			The Internal Oblique Muscle
			The Transversus Abdominis Muscle
		1.1.2 Fasciae and Fascial Structures
			Subcutaneous (Camper) Fascia or Fatty Layer of the Abdomen
			Superficial Abdominal Fascia (Scarpa fascia) or Membranous Layer of the Abdomen
			The Rectus Sheath
			The Linea Alba
			The Transversalis Fascia
			Peritoneum
			Inguinal Ligament
			Inguinal Falx (Conjoint Tendon)
			Interfoveolar Ligament (of Hesselbach)
		1.1.3 Anatomical Regions and Hernial Orifices
			Inguinal Canal with Superficial and Deep Inguinal Rings
			Muscular Lacuna
			Vascular Lacuna and Femoral Ring
			The Inguinofemoral Region
		1.1.4 Laparoscopic Anatomy
	1.2 Definition and Terminology
		1.2.1 Hernia
		1.2.2 Structure of a Hernia
		1.2.3 Hernia Disease
		1.2.4 Incarceration
		1.2.5 Hernia Location
	1.3 Diagnosis
		1.3.1 History
		1.3.2 Examination
		1.3.3 Differential Diagnosis.
		1.3.4 Investigations
			Plain X-Ray of the Abdomen
			Gastrointestinal or Colon Imaging with Water-Soluble Contrast Agent
			Herniography (Peritoneography)
			Computed Tomography, Magnetic Resonance Imaging
		1.3.5 Ultrasonography
			Equipment and Examination Technique
			Ultrasonographic Hernia Criteria
			Ultrasonographic Differential Diagnosis of Pathological Findings in the Abdominal Wall and Groin
		1.3.6 Doppler Ultrasonography, Duplex Ultrasonography
	1.4 The History of Hernia Surgery
		1.4.1 Definition, Anatomy, and Pathogenesis
		1.4.2 Conservative Treatment
		1.4.3 Surgery
	1.5 Repair Principles and Materials
		1.5.1 Choice of Procedure
			The Patient
			Hernia Type
			Operation Techniques
		1.5.2 Principles for Choice of Procedure
		1.5.3 Basic Hernia Repair Procedures
			Inguinal Hernias
			Abdominal Wall
		1.5.4 Materials
	1.6 Hernia Biomechanics
		1.6.1 Introduction
			Muscle Forces in the Abdominal Wall
			Linea Alba
		1.6.2 Mechanics of Hernia Surgery with Mesh Reinforcement
			Material Properties of Hernia Meshes
			Prosthesis Overlapping
			Bulging
			Fixation of Plastics
	1.7 Biological Meshes
		1.7.1 Introduction and Basic Principles
		1.7.2 Biomechanical Principle of Mesh Augmentation
		1.7.3 Biological Materials
			Biological Cross-Linked and Non-Cross-Linked Membranes (Collagenase Resistance)
		1.7.4 Indications and Complications of Biological Membranes
	1.8 Anesthesia
		1.8.1 General Anesthesia
		1.8.2 Epidural and Spinal Anesthesia
		1.8.3 Local Anesthesia
			Local Anesthesia Technique
	1.9 Pediatric Hernia
		1.9.1 Indication
		1.9.2 Preparation for Operation
		1.9.3 Special Risks and Informed Consent
		1.9.4 Anesthesia
		1.9.5 Position
		1.9.6 Access
		1.9.7 Relevant Anatomy, Dangers, and Tricks
		1.9.8 Management of Special Complications
		1.9.9 Postoperative Care
		1.9.10 Operation Techniques
			Inguinal Hernia Operation in Boys
			Hydrocele
			Inguinal Hernia Surgery in Girls
			Inguinal Testis
		1.9.11 Laparoscopy
2 Adult Inguinal Hernia
	2.1 Indications and Choice of Procedure
		2.1.1 Indications
			Choice of Procedure
	2.2 Open Suture Techniques
		2.2.1 Approach and Dissection
			Indication
			Operation Preparation
			Special Risks, Informed Consent
			Anesthesia
			Position
			Access
			Relevant Anatomy, Dangers, and Tricks
			Management of Special Complications
			Postoperative Management
			Operation Techniques
		2.2.2 Hernia Repair
			Bassini Repair
			The Zimmerman Repair
			Minimal Repair Technique
			Shouldice Repair
			Lotheissen/McVay Repair
	2.3 Open Mesh Techniques
		2.3.1 Lichtenstein Repair
			Repair Principle
			Indication
			Operation Techniques
		2.3.2 Transinguinal Preperitoneal Patch
			Repair Principle
			Indication
			Operation Techniques
		2.3.3 Nyhus Repair with Mesh
			Repair Principle
			Indications
			Operation Techniques
		2.3.4 The Stoppa/Wantz Procedure
			Indications
			Contraindications
			Material
			Preparation
			Anesthesia
			Position
			Postoperative Care
			Operation Techniques
		2.3.5 Three-dimensional Mesh Procedures
			Introduction and History: The Gilbert Technique with the Prolene Hernia System/Ultrapro Hernia System
			Operation Techniques
			Summary
		2.3.6 Plug and Patch
			Indications
			Equipment
			Operative Principle
			Operation Techniques
	2.4 Laparoscopic Techniques
		2.4.1 Transabdominal Preperitoneal Mesh
			Historical Development
			Indications
			Informed Consent, Preoperative Preparation, Perioperative Management
			Anesthesia
			Patient and Operator Position
			Trocar Choice and Position
			Pneumoperitoneum Creation
			Operation Techniques
			Learning Curve Results with Simple and Difficult Hernias
			Comparison of TAPP with TEP
		2.4.2 Totally Extraperitoneal Mesh Repair (TEP)
			Introduction
			Operation Techniques
			Special Aspects
			Results
			TEP: Indications and Contraindications
		2.4.3 Minitechnique
			Introduction
			Instruments
			Operation techniques
3 Special Hernias
	3.1 Female Hernias
		3.1.1 Operation Tactics
		3.1.2 Operation Techniques
	3.2 Sportsman\'s Groin
		3.2.1 History
		3.2.2 Diagnosis
			Clinical Examination
			Ultrasonography
			Magnetic Resonance Imaging and Computed Tomography
			Herniography
		3.2.3 Treatment
		3.2.4 Summary
	3.3 Sliding Hernia
	3.4 Recurrent Hernia
		3.4.1 General Remarks/Epidemiology
		3.4.2 Risk Factors
		3.4.3 Forms and Location
		3.4.4 Choice of Procedure
		3.4.5 Preparation
		3.4.6 Dissection and Repair
		3.4.7 Complications
	3.5 Umbilical Hernia
		3.5.1 Epidemiology and Pathogenesis
		3.5.2 Diagnosis and Classification
		3.5.3 Indications
		3.5.4 Complications
		3.5.5 Operation Technique
			Spitzy Repair
			Preperitoneal Umbilical Mesh Plasty
	3.6 Femoral Hernia
		3.6.1 Basic Principles
			General Remarks
			The Hernial Orifice
			Pathogenesis
			Diagnosis
		3.6.2 Indications
		3.6.3 Preparation, Anesthesia, and Positioning
		3.6.4 Operation Tactics
		3.6.5 Forms of Repair
			Crural Access
			Inguinal Access
			Preperitoneal Access
		3.6.6 Operation Techniques
			Crural Access
			Inguinal Access
			Alloplastic Repair
	3.7 Rare Hernias
		3.7.1 Lumbar Hernia
			Location
			Symptoms
			Operation Techniques
		3.7.2 Supravesical Hernia
			Location
			Symptoms
			Operation Techniques
		3.7.3 Obturator Hernia
			Location
			Symptoms
			Operation Techniques
		3.7.4 Sciatic Hernia
			Location
			Symptoms
			Operation Techniques
		3.7.5 Perineal Hernia
			Location
			Symptoms
			Operation Techniques
		3.7.6 Interparietal Hernias
			Location
			Symptoms
			Operation Techniques
	3.8 Spigelian Hernia
		3.8.1 Definition, Anatomy, and Incidence
		3.8.2 Diagnosis and Choice of Procedure
		3.8.3 Results and Complications
		3.8.4 Operation Techniques
	3.9 Internal Hernias
		3.9.1 Anatomy
		3.9.2 Incidence
		3.9.3 Diagnosis
		3.9.4 Indications
		3.9.5 Anesthesia
		3.9.6 Position
		3.9.7 Access
		3.9.8 Complications
		3.9.9 Results
		3.9.10 Operation Techniques
4 Incisional Hernias
	4.1 General Principles
		4.1.1 Definition
		4.1.2 Diagnosis
		4.1.3 Classification
		4.1.4 Indications
		4.1.5 Preoperative Preparation and Informed Consent
		4.1.6 Anesthesia
		4.1.7 Position
		4.1.8 Operation Tactics
		4.1.9 Perioperative Management
	4.2 Open Technique
		4.2.1 Open Sublay (Retromuscular Augmentation)
			Operation Techniques
			Relevant Anatomy, Dangers, and Tricks
			Management of Special Complications
			Postoperative Care
		4.2.2 Open Onlay (Epifascial Mesh Augmentation)
			Operation Techniques
			Relevant Anatomy, Dangers, and Tricks
			Management of Special Complications
			Postoperative Care
		4.2.3 Open Intraperitoneal Onlay Mesh Technique
			Introduction
			Operation Techniques
			Advantages and Disadvantages
			Summary
	4.3 Laparoscopic Repair of Incisional Hernias
		4.3.1 General Principles
			Indications
			Contraindications
			Operation Techniques
			Postoperative Care
			Unanswered Questions
			Summary
		4.3.2 Endoscopic Totally Extraperitoneal Transhernial Sublay Ventral Hernia Repair using the Single-Port Technique
			Indications
			Operation Preparation
			Special Risks, Informed Consent
			Anesthesia
			Position
			Access
			Relevant Anatomy, Dangers, and Tricks
			Management of Special Complications
			Postoperative Care
			Operation Techniques
		4.3.3 Laparoscopic Repair of Parastomal Hernias
			Keyhole Technique
			Sugarbaker Technique
			Sandwich Technique
			Postoperative Care
			Limits of the Laparoscopic Technique
			Summary
		4.3.4 Open Repair of Parastomal Hernias
			Indications
			Operation Preparation
			Special Risks, Informed Consent
			Anesthesia
			Positioning
			Operation Technique 1: Retromuscular Mesh Position
			The Sugarbaker Intraperitoneal Mesh Operation Technique
			Postoperative Care
		4.3.5 Preoperative Progressive Pneumoperitoneum
			Physiological Basis
			Indications
			Contraindications
			Technique
			Complications
			Results
			Conclusion
		4.3.6 Giant Incisional Hernia
			Diagnosis
			Indications
			Preoperative Preparation and Informed Consent
			Anesthesia
			Position
			Operation Tactics
			Perioperative Management
			Repair Techniques
			Postoperative Care
		4.3.7 Posterior Component Separation According to Rosen
			Indications
			Diagnosis and Operation Preparation
			Special Risks, Informed Consent
			Anesthesia
			Position
			Access
			Operation Steps
			Relevant Anatomy, Dangers, and Tricks
			Management of Special Complications
			Postoperative Care
			Summary
		4.3.8 Anterior Component Separation According to Ramirez
			Basis
			Indications
			Operation Techniques
		4.3.9 Endoscopic Component Separation
			Indications
			Diagnosis and Operation Preparation
			Special Risks, Informed Consent
			Anesthesia
			Position
			Access
			Operation Steps
			Relevant Anatomy, Dangers, Tricks
			Management of Special Complications
			Postoperative Care
		4.3.10 Laparostomy Hernias
			Treatment
			Summary
	4.4 Abdominal Wall Tumors
		4.4.1 Epidemiology
		4.4.2 Clinical Symptoms
		4.4.3 Diagnosis
			Diagnostic Imaging
			Differential Diagnosis
			Pathological Diagnosis
		4.4.4 Treatment
			Conservative
			Surgical
			Adjuvant Therapy
		4.4.5 Prognosis
	4.5 Prevention of Incisional Hernias
		4.5.1 Abdominal Wall Closure Techniques
			Dissection of the Linea Alba
			Closure
		4.5.2 Indications for Prophylactic Mesh Reinforcement
		4.5.3 Prophylactic Mesh Reinforcement Operation Procedure
			Initial Dissection of the Linea Alba
			Operation Procedure: Onlay Mesh
			Operation Procedure: Sublay Mesh
		4.5.4 Postoperative Management
5 Complications
	5.1 Infection
		5.1.1 Introduction
		5.1.2 Definition
		5.1.3 Infections in Inguinal Hernia Surgery
		5.1.4 Infections in Incisional Hernia Surgery
		5.1.5 Prevention of Wound Infections
		5.1.6 Treatment of Wound and Mesh Infections in Hernia Surgery
	5.2 Incarceration
		5.2.1 Etiology
		5.2.2 Clinical Features
		5.2.3 Diagnosis
		5.2.4 Treatment
		5.2.5 Incarceration Rates and Risk
	5.3 Postoperative Pain
		5.3.1 Acute Postoperative Pain
		5.3.2 Chronic Postoperative Pain after Inguinal and Femoral Hernia Operation
	5.4 Triple Neurectomy
		5.4.1 Diagnosis
		5.4.2 Indications
		5.4.3 Operation Techniques
		5.4.4 Results
6 Miscellaneous
	6.1 Training in Hernia Surgery: Hernia Compact—Young Surgery as a 3-Day Further Education Course
	6.2 Hernia Register: Outcome Research in Hernia Surgery
		6.2.1 Patient Data and Methodology
			Project
			Informed Consent
			Recording of Clinical Data
			Data Protection
			Data Retrieval
			Follow-up
Index