Lec-01 abdominalwall_hernias

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Lec-01 abdominalwall_hernias Powered By Docstoc
					Abdominal Wall Hernias
     Presented by Dr. Shannon Fraser
              General Surgeon – JGH
              Types of Hernias

   Inguinal
       Indirect
       Direct
   Femoral
   Umbilical
   Epigastric
   Spigelian
   Incisional
Groin Hernias
Femoral and Inguinal
     Hernias
No Size Limit
Umbilical Hernia
Incisional Hernia
          Types of Hernias

 Reducible
 Non-reducible
     Incarcerated
     Sliding
     Strangulated
Strangulated Inguinal Hernia
Strangulated Bowel
           Dangerous Hernias
           Without Obstruction
   Richter’s hernia
       Strangulation of a portion of the bowel
        wall
   Litre’s hernia
       Meckel’s diverticulum
             Inguinal Hernia

   Indirect
     Through internal ring
     Hernia sac with the spermatic cord
     Anterior medial to cord structures

   Direct
     Hernia through inguinal floor
      (transversalis)
     In Hesselbach’s triangle
Anatomy
Inguinal Anatomy
              Femoral Hernia

 Comes through femoral canal
 Boundaries of canal:
    Anterior = inguinal ligament
    Posterior = pubic ramus and pectineal
      fascia
    Medial = pubic tubercle/ lacunar ligament
    Lateral = femoral vein
   Within canal:
       NAVEL (lateral to medial)
        Inguinal Hernia Repairs

   Open
     Lichtenstein
     McVay
     Shouldice
     Bassini
     Preperitoneal
   Laparoscopic
     TEP (totally extraperitoneal repair)
     TAPP (transabdominal preperitoneal
      repair)
Open Shouldice Repair
Open Incisional
 Hernia Repair
Questions?

				
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