Advertisement

Primary Femoral Hernia: Open Anterior Treatment

  • Stefano Mandalà
  • Camillo La Barbera
  • Cosimo Callari
  • Antonino Mirabella
  • Vincenzo Mandalà
Chapter

Abstract

A femoral hernia is an acquired and direct hernia. It is an insidious hernia often asymptomatic; in 30% of cases, the onset is a strangulation, with bowel resection and mortality. In literature, there are three main types of approach. The authors describe an anterior femoral approach performed in the last two decades, with a double disc prosthesis fashioned in a tailored prosthetic repair, with the use of four prosthetic devices according to the characteristics of the femoral ring and femoral canal. The authors show, in detail, the technical steps of this anterior prosthetic procedure, and they highlight some peculiarities in emergency. Finally, they mention their personal series and good results with this technique, which, in their opinion, is fast, reproducible and so easy to perform and to learn.

References

  1. 1.
    Nyhus LM, Klein MS, Rogers FB. Inguinal hernia. Curr Probl Surg. 1991;28(6):401–50.CrossRefPubMedGoogle Scholar
  2. 2.
    Miserez M, Alexandre JH, Campanelli G, Corcione F, Cuccurullo D, Pascual MH, Hoeferlin A, Kingsnorth AN, Mandala V, Palot JP, Schumpelick V, Simmermacher RK, Stoppa R, Flament JB. The European hernia society groin hernia classification: simple and easy to remember. Hernia. 2007;11(2):113–6.CrossRefPubMedGoogle Scholar
  3. 3.
    Bendavid R. Femoral hernias: why do they recur? Prob Gen Surg. 1995;12(2):147–9.Google Scholar
  4. 4.
    Nilsson H, Stylianidis G, Haapamavski M, Nilsson E, Nordin P. Mortality after groin hernia surgery. Ann Surg. 2007;245(4):656–60.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Humes DJ, Radcliffe RS, Camm C, West J. Population-based study of presentation and adverse outcomes after femoral hernia surgery. Br J Surg. 2013;100(13):1827–32.CrossRefPubMedGoogle Scholar
  6. 6.
    Dahlstrand U, Wollert S, Nordin P, Sandblom G, Gunnarsson U. Emergency femoral hernia repair: a study based on a national register. Ann Surg. 2009;249(4):672–6.CrossRefPubMedGoogle Scholar
  7. 7.
    Chan G, Chan CK. Long term results of a prospective study of 225 femoral hernia repairs: indications for tissue and mesh repair. J Am Coll Surg. 2008;207(3):360–7.CrossRefPubMedGoogle Scholar
  8. 8.
    Chen J, Lv Y, Shen Y, Liu S, Wang M. A prospective comparison of preperitoneal tension-free open herniorrhaphy with mesh plug herniorrhaphy for the treatment of femoral hernias. Surgery. 2010;148(5):976–81.CrossRefPubMedGoogle Scholar
  9. 9.
    Bocchi P. Paravascular hernias. In: Bendavid R, editor. Prostheses and abdominal wall hernias. Austin: R.G. Landes Company; 1994.Google Scholar
  10. 10.
    Putnis S, Wong A, Berney C. Synchronous femoral hernias diagnosed during endoscopic inguinal hernia repair. Surg Endosc. 2011;25(12):3572–4.CrossRefGoogle Scholar
  11. 11.
    Henriksen NA, Thorup J, Jorgensen LN. Unsuspected femoral hernia in patients with a preoperative diagnosis of recurrent inguinal hernia. Hernia. 2012;16(4):381–5.CrossRefPubMedGoogle Scholar
  12. 12.
    Cox TC, Huntington TR, Blair LJ, Prasad T, Heniford BT, Augenstein VA. Quality of life and outcomes for femoral hernia repair: does laparoscopy have an advantage? Hernia. 2017;21(1):79–88.CrossRefPubMedGoogle Scholar
  13. 13.
    Dahlstrand U, Sandblom G, Nordin P, Wollert S, Gunnarsson U. Chronic pain after femoral Hernia repair: a cross-sectional study. Ann Surg. 2011;254(6):1017–21.CrossRefPubMedGoogle Scholar
  14. 14.
    Andresen K, Bisgaard T, Kehlet H, Wara P, Rosenberg J. Reoperation rates for laparoscopic vs open repair of femoral hernias in Denmark: a nationwide analysis. JAMA Surg. 2014;149(8):853–7.CrossRefPubMedGoogle Scholar
  15. 15.
    Eker H, Schouten N, Bury K, Muysoms F. World Guidelines for Groin Hernia Management. The HerniaSurge Group. PART 2 Specific Aspects of Groin Hernia Management. Chapter 17 “Femoral hernias” 2017.Google Scholar
  16. 16.
    Mandalà V, Di Marco F, Lupo M, Mirabella A. Femoral hernias PHS MESH-Plug technique repair. In: Corcione F, editor. New procedures in open hernia repair. Paris: Springer; 2004.Google Scholar
  17. 17.
    Mandalà V, Di Marco F, Lupo M, Mirabella A, Mandalà S. Hernie crurale avec PHS in Video-Atlas Chirurgie Herniarie: I. Hernie de l’aine, techniques ouverts (French Edition) Cavit Avci, Gilles Fourtanier, Levent Avtan. Springer; 2011.Google Scholar
  18. 18.
    Amid PK, Shulman AG, Lichtenstein IL. The femoral canal: the key to femoral herniorrhaphy. Int Surg. 1990;75(2):69–72.PubMedGoogle Scholar
  19. 19.
    Amid PK, Shulman AG, Lichtenstein IL. Femoral hernia resulting from inguinal herniorrhaphy: the “plug” repair. Cont Surg. 1991;39:19–24.Google Scholar
  20. 20.
    Mikkelsen T, Bay-Nielsen M, Kehlet H. Risk of femoral hernia after inguinal herniorrhaphy. Br J Surg. 2002;89(4):486–8.CrossRefPubMedGoogle Scholar
  21. 21.
    Peacock EE Jr, Madden JW. Studies on the biology and treatment of recurrent inguinal hernia. II. Morphological changes. Ann Surg. 1974;179(5):567–71.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Lichntenstein IL, Shore JM. Simplified repair of femoral and recurrent inguinal hernias by a “plug” technique. Am J Surg. 1974;128:439–44.CrossRefGoogle Scholar
  23. 23.
    Gilbert AI. Generations of the plug and patch repair: its development and lessons from history, mastery of surgery. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2007. p. 1940–3. Chapter 177.Google Scholar
  24. 24.
    Trabucco E, Campanelli P, Cavagnoli R. New polypropylene hernia prosthesis. Minerva Chir. 1998;53(4):337–41. Italian.PubMedGoogle Scholar
  25. 25.
    Rutkow IM. The PerFix plug repair for groin hernias. Surg Clin North Am. 2003;83(5):1079–98. vi.CrossRefPubMedGoogle Scholar
  26. 26.
    Bendavid R. Prostheses and abdominal wall hernias. Austin: RG Landes Company; 1994.Google Scholar
  27. 27.
    Bendavid R. New techniques in hernia repair. World J Surg. 1989;13(5):522–31.CrossRefPubMedGoogle Scholar
  28. 28.
    Scott NW, McCormack K, Graham P, Go PM, Ross SJ, Grant AM. Open mesh versus non-mesh for repair of femoral and inguinal hernia. Cochrane Database Syst Rev. 2002;4:CD002197.Google Scholar
  29. 29.
    Gilbert AI, Graham MF, Voigt WJ. A bilayer patch device for inguinal hernia repair. Hernia. 1999;3(3):161–6.CrossRefGoogle Scholar
  30. 30.
    Romain B, Chemaly R, Meyer N, Brigand C, Steinmez JP, Rohr S. Prognostic factors of postoperative morbidity and mortality in strangulated groin hernia. Hernia. 2012;16(4):405–10.CrossRefPubMedGoogle Scholar
  31. 31.
    Chia CF, Chan WH, Yau KW, Chan C. Emergency femoral hernia repair: 13-year retrospective comparison of the three classical open surgical approaches. Hernia. 2017;21(1):89–93.CrossRefPubMedGoogle Scholar
  32. 32.
    Sgourakis G, Radtke A, Sotiropoulos GC, Dedemadi G, Karaliotas C, Fouzas I, Karaliotas C. Assessment of strangulated content of the spontaneously reduced inguinal hernia via hernia sac laparoscopy: preliminary results of a prospective randomized study. Surg Laparosc Endosc Percutan Tech. 2009;19(2):133–7.CrossRefPubMedGoogle Scholar
  33. 33.
    Morris-Stiff G, Hassn A. Hernioscopy: a useful technique for the evaluation of incarcerated hernias that retract under anaesthesia. Hernia. 2008;12:133–5.CrossRefPubMedGoogle Scholar
  34. 34.
    Song Y, Lu A, Ma D, Wang Y, Wu X, Lei W. Long-term results of femoral hernia repair with ULTRAPRO Plug. J Surg Res. 2015;194(2):383–7.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Stefano Mandalà
    • 1
    • 2
  • Camillo La Barbera
    • 1
    • 2
  • Cosimo Callari
    • 1
  • Antonino Mirabella
    • 3
  • Vincenzo Mandalà
    • 1
  1. 1.Department of General SurgeryBuccheri La Ferla HospitalPalermoItaly
  2. 2.Unit of General Surgery, Noto-Pasqualino HospitalPalermoItaly
  3. 3.General and Emergency Surgery, Villa Sofia—Cervello HospitalsPalermoItaly

Personalised recommendations