Abstract
This report describes the surgical management of a giant inguinoscrotal hernia, which extended below the patient’s knees, causing considerable physical discomfort and impairment of his quality of life. Initial management involved improving the patient’s general condition and performing progressive preoperative pneumoperitoneum over 18 days. Surgery involved debulking the contents of the massive hernia sac by performing right hemicolectomy and transverse colectomy, repositioning of the small bowel into the abdominal cavity, resection of the giant hernia sac, and plastic reconstruction of the penis and scrotal region. The abdominal wall was reinforced with composite mesh. Despite a complicated postoperative course, the patient recovered well and has progressively returned to normal activities. Although challenging and demanding, surgery represents the only mode of treatment that can offer the patient with a giant inguinoscrotal hernia a satisfactory level of function and quality of life.
Similar content being viewed by others
References
Serpell JW, Polglase AL, Anstee EJ. Giant inguinal hernia. Aust NZ J Surg 1988;58:831–834.
Hodgkinson DJ, McIlrath DC. Scrotal reconstruction for giant inguinal hernias. Surg Clin North Am 1980;64:307–313.
Moss G. Techniques to aid in hernia repair complicated by the loss of domain. Surgery 1975;78:408.
Mehendale FV, Taams KO, Kingsnorth AN. Repair of a giant inguinoscrotal hernia. Br J Plast Surg 2000;53:525–529.
Ek EW, Ek ET, Bingham R, Wilson J, Mooney B, Banting SW, et al. Component separation in the repair of a giant inguinoscrotal hernia. Aust NZ J Surg 2006;76:950–952.
Sturniolo G, Tonante A, Gagliano E, Taranto F, Lo Schiavo MG, D’Alia C. Surgical treatment of the giant inguinal hernia. Hernia 1999;3:27–30.
Udwadia TE. Stomach strangulated in inguinal hernia presenting with hematemesis. Int Surg 1984;69:177–179.
Weitzenfeld MB, Brown BT, Morillo G, Block NL. Scrotal kidney and ureter: an unusual hernia. J Urol 1980;123:437–438.
Merrett ND, Waterworth MW, Green MF. Repair of giant inguinoscrotal inguinal hernia using marlex mesh and scrotal skin flaps. Aust NZ J Surg 1994;64:380–383.
Forrest J. Repair of massive inguinal hernia. Arch Surg 1979;114: 1087–1088.
Kyle SM, Lovie MJ, Dowle CS. Massive inguinal hernia. Br J Hosp Med 1990;43:383–384.
Barst HH. Pneumoperitoneum as an aid in the surgical treatment of giant herniae. Br J Surg 1972;59:360–364.
Stoppa RE. The treatment of complicated groin and incisional hernias. World J Surg 1989;13:545–554.
Willis S, Schumpelick V. Use of progressive pneumoperitoneum in the repair of giant herniae. Hernia 2000;4:105–111.
El-Dessouki NI. Preperitoneal mesh hernioplasty in giant inguinoscrotal hernias: a new technique with dual benefit in repair and abdominal rooming. Hernia 2002;5:177–181.
Mathes SJ, Steinwald PM, Foster RD, Hoffman WY, Anthony JP. Complex abdominal wall reconstruction: a comparison of flap and mesh closure. Ann Surg 2000;4:586–596.
El Saadi AS, Al Wadan AH, Hamerna S. Approach to a giant inguinoscrotal hernia. Hernia 2005;9:277–279.
Hayami S, Hotta T, Takifuji K, Iwahashi M, Mitani Y, Yamaue H. Reconstruction of an infected recurrent ventral hernia after a mesh repair using a pedicled tensor fascia lata flap: report of two cases. Surg Today 2009;39:811–817.
Author information
Authors and Affiliations
Additional information
K. Vasiliadis and H.-P. Knaebel contributed equally to this study.
Rights and permissions
About this article
Cite this article
Vasiliadis, K., Knaebel, HP., Djakovic, N. et al. Challenging surgical management of a giant inguinoscrotal hernia: Report of a case. Surg Today 40, 684–687 (2010). https://doi.org/10.1007/s00595-009-4125-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00595-009-4125-3