inguinal hernia 2 ,theory part for surgery .pptx

inginal hernia theory

1. Inguinal hernia

2. Statistics:- Epidemiology:- Symptoms present in 66% of affected individuals. Male to Female 9 to 1 Indirect hernia more in young age group. Direct hernia tends to increase in older age group. Inguinal hernia occurs more often on Right side than left.

3. In 2015 the inguinal hernia affected 18.5 million WW. 27% of male and 3% of female will have groin hernia. It resulted in 60,000 death in 2015 and 55,000 in 1990

4. Risk factors increase intraabdominal pressure Chronic cough (smoking, COPD, Constipation Pregnancy Straining at micturition. Severe muscular effort e.g. lifting heavy objects. Ascitis Peritoneal dialysis. collagen vascular disease

5. Previous open appendectomy Genetic :- tends to happen in certain families.

6. Inguinal canal anatomy

7. Inguinl canal contents Male: spermatic cord structure: Vas deference. Testicular artery and veins ( pampiniform plexus) Genital branch of genitofemoral nerve Ilioinguinal nerve Procesus vaginalis Artery of vas deference. Autonomic nerves, lymphatics.

8. Female inguinal canal contents:- Round ligament Genital branch of genitofemoral nerve. Autonomic nerves, lymphatics.

9. Anatomy

10. Signs and symptoms Recurrent lump at certain position that enlarge on straining causing discomfort. Clinical examination:- Cough impulse + ve Reducibility.

11. Examples:-

12. Diagnosis:-

13. Hernia imaging

14. T ypes Indirect inguinal hernia, latera to inferior epigastric vessel covered by internal spermatic fascia  congenital and adulthood. Via internal inguinal ring. D irect inguinal hernia, medial to inferior epigastric vessel. Not covered by fascia Adult onset. Weakness in hasselbach triangle.

15. Hasselbach triangle

16. Management Surgical treatment . Types of surgery:- 1- permenant suture technique e.g.shouldice 2- permenant mesh e.g. Lichtenstein. In addition to treating the risk factors such as COPD, prostate…etc.

17. Non surgical option

18. Ancient therapy