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Laparoskopik Yaklaşım ile Saptanan İnsidental Femoral Herniler: Cinsiyet Önemli Mi?

Year 2023, Volume: 6 Issue: 1, 51 - 55, 30.04.2023

Şiyar Ersöz , Yasemin Konuk , Deniz Kütük , Akın Fırat Kocaay , Murat Türkeün Ilgınel , Atıl Çakmak

https://doi.org/10.36516/jocass.1251912

Abstract

Giriş: Laparoskopik inguinal herni onarımı, kasık bölgesinde fıtık oluşturabilecek bölgelerin bilateral olarak görülmesine olanak tanıyarak preoperatif fizik muayene ile tanı konulamamış fıtıkların teşhisini sağlar. Bu çalışma ile laparoskopik inguinal herni onarımı sırasında intraoperatif tanı konulan femoral fıtıkların insidansının gösterilmesi amaçlanmıştır.

Gereç ve Yöntem: Eylül 2014-Ağustos 2019 tarihleri arasında xxx Hastanesinde laparoskopik inguinal herni onarımı yapılan 865 hasta retrospektif olarak incelenmiştir. Hastaların demografik verileri, operasyon esnasındaki ve sonrasındaki klinik takipleri incelenmiştir.

Sonuç: Eylül 2014 ve Ağustos 2019 tarihleri arasında, 865 hastaya kliniğimizde laparoskopik inguinal herni onarımı yapılmıştır. 822 hasta erkek, 43 hasta kadın olarak gruplandırılmıştır. 841 hastaya ekstraperitoneal yaklaşım (TEP) uygulanmış olup 24 hastaya transabdominal preperitoneal (TAPP) yöntemi uygulanmıştır. 3 hastanın ameliyatı TEP yöntemi ile başlamış olup peritoneal hasar nedeni ile TAPP yöntemi ile devam edilmiştir. 41 adet TEP, 17 adet TAPP yapılan toplam 58 hastada (%6,7) laparoskopik herni onarımının karın duvarının posteriorundan yapılması sayesinde rastlantısal femoral herni saptanmıştır. Bu hastaların 3 tanesi kadın, 55 tanesi ise erkek olarak tespit edilmiştir. Ameliyatlar esnasında rastlantısal saptanan femoral hernilerin onarımı da gerçekleştirilmiştir.

Tartışma: Sonuç olarak; preoperatif tanı konulmamış femoral herniler, inguinal kanalın preperitoneal diseksiyonu sayesinde intraoperatif saptanabilir ve aynı operasyon seansında onarılabilir. Literatüre göre femoral herni sıklığının kadınlarda erkeklere göre daha fazla olmasına rağmen bu çalışmada insidental olarak tanı konulan femoral herni oranının erkeklerde kadınlara göre daha fazla olduğu izlenmiştir.

Keywords

insidental femoral herni oranları inguinal herni laparoskopik herni onarımı

References

  • 1. Bay-Nielsen M, Kehlet H, Strand L, et al. Quality assessment of 26 304 herniorrhaphies in Denmark: a prospective nationwide study. Lancet 2001;358:1124–28. https://doi.org/10.1016/S0140-6736(01)06251-1
  • 2. Fitzgibbons RJ, Richards AT, Quinn TH. Open hernia repair. In: Souba WS, Mitchell P, Fink MP, Jurkovich GJ, Kaiser LR, Pearce WH, Pemberton JH, Soper NJ. ACS Surgery: Principles and Prac-tice. 6th ed., Decker Publishing Inc., Philadelphia, U.S.A. p. 828-49, 2002.
  • 3. Kulacoglu H. Current options in inguinal hernia re¬pair in adult patients. Hippokratia 2011;15(3): 223-31.
  • 4. Old OJ, Kulkarni SR, Hardy TJ, et al. Incidental non-inguinal hernias in totally extra-peritoneal hernia repair, Ann R Coll Surg Engl 2015;97:120–4. https://doi.org/10.1308/003588414X14055925058959
  • 5. Shimizu S, Uchiyama A, Mizumoto K, et al Lapa¬roscopically assisted distal gastrectomy for early gastric cancer. Is it superior to open surgery? Surg Endosc 2000;14:27–31. https://doi.org/10.1007/s004649900005
  • 6. Lacy AM, Garcia-Valdecasas JC, Delgado S, et al. Laparoscopic-assisted colectomy versus open co¬lectomy for treatment of non-metastatic colon can¬cer: a randomized trial. Lancet 2002;359(9325):2224–9. https://doi.org/10.1016/S0140-6736(02)09290-5
  • 7. Dulucq JL, Wintringer P, Mahajna A. Occult her-nias detected by laparoscopic totally extra-perito-neal inguinal hernia repair: a prospective study. Hernia. 2011;15:399–402. https://doi.org/10.1007/s10029-011-0795-z
  • 8. Koch A, Edwards A, Haapaniemi S, et al. Prospec¬tive evaluation of 6895 groin hernia repairs in women. Br J Surg 2005;92:1553–8. https://doi.org/10.1002/bjs.5156
  • 9. Crawford DL, Hiatt JR, Phillips EH. Laparoscopy identifies unexpected groin hernias. Am Surg. 1998;64:976–8.
  • 10. Henriksen NA, Thorup J, Jorgensen LN. Unsus-pected femoral hernia in patients with a preopera¬tive diagnosis of recurrent inguinal hernia. Hernia. 2012;16:381–5. https://doi.org/10.1007/s10029-012-0924-3
  • 11. Mikkelsen T, Bay-Nielsen M, Kehlet H. Risk of femoral hernia after inguinal herniorrhaphy. Br J Surg. 2002; 89:486–8. https://doi.org/10.1046/j.0007-1323.2002.02058.x
  • 12. Bay-Nielsen M, Kehlet H. Inguinal herniorrhaphy in women. Hernia. 2006;10:30–3. https://doi.org/10.1007/s10029-005-0029-3
  • 13. Simons MP, Aufenacker T, Bay-Nielsen M, et al. European Hernia Society guidelines on the treat-ment of inguinal hernia in adult patients. Hernia. 2009;13:343–403. https://doi.org/10.1007/s10029-009-0529-7

Incidental Femoral Hernias Diagnosed by Laparoscopic Approach: Does Gender Really Matter?

Year 2023, Volume: 6 Issue: 1, 51 - 55, 30.04.2023

Şiyar Ersöz , Yasemin Konuk , Deniz Kütük , Akın Fırat Kocaay , Murat Türkeün Ilgınel , Atıl Çakmak

https://doi.org/10.36516/jocass.1251912

Abstract

Introduction: Laparoscopic approach in hernia repair enables to visualize all hernia orifices in the groin bilaterally and it may reveal a hernia in the groin region which had not been diagnosed with preoperative physical examination. Therefore, we aim to show incidence of incidental femoral hernias which are diagnosed during laparoscopic inguinal hernia repair.

Material and Methods: In this retrospective study 865 cases of inguinal hernia that underwent laparoscopic approach for inguinal hernia repair at the xxx between September 2014 and August 2019 were included. The patients’ demographic data, operative and postoperative course were studied.

Results: Between September 2014 and August 2019 865 cases of inguinal hernia underwent laparoscopic hernia repair in our institute. 822 of patients were male and 43 were female. 841 cases underwent totally extraperitoneal (TEP) and 24 cases had trans-abdominal preperitoneal (TAPP) repair. 3 of the operations had started with TEP approach, due to peritoneal injury finished with TAPP. Inferior epigastric artery injury occurred 6 of TEP and 1 of TAPP patients, there were managed by laparoscopic sealing of the damaged vessels. 58 (41 TEP and 17 TAPP) of patients were diagnosed femoral hernia incidentally thanks to posterior approach of laparoscopic hernia repair within 865 patients (6,7%). 3 of these patients was female and 55 were male. During the operation femoral hernia repair was also performed to them.

Conclusion: In conclusion femoral hernias, which had not been diagnosed preoperatively, can be incidentally diagnosed intraoperatively due to dissection of preperitoneal inguinal canal and hernias can be repaired at the same operation. Although ratio of femoral hernia for female patients is higher than the male patients in the literature, in this report ratio of femoral hernias diagnosed incidentally is similar between females and males.

Keywords

i̇ncidental rate of femoral hernia i̇nguinal hernia laparoscopic hernia repair

References

  • 1. Bay-Nielsen M, Kehlet H, Strand L, et al. Quality assessment of 26 304 herniorrhaphies in Denmark: a prospective nationwide study. Lancet 2001;358:1124–28. https://doi.org/10.1016/S0140-6736(01)06251-1
  • 2. Fitzgibbons RJ, Richards AT, Quinn TH. Open hernia repair. In: Souba WS, Mitchell P, Fink MP, Jurkovich GJ, Kaiser LR, Pearce WH, Pemberton JH, Soper NJ. ACS Surgery: Principles and Prac-tice. 6th ed., Decker Publishing Inc., Philadelphia, U.S.A. p. 828-49, 2002.
  • 3. Kulacoglu H. Current options in inguinal hernia re¬pair in adult patients. Hippokratia 2011;15(3): 223-31.
  • 4. Old OJ, Kulkarni SR, Hardy TJ, et al. Incidental non-inguinal hernias in totally extra-peritoneal hernia repair, Ann R Coll Surg Engl 2015;97:120–4. https://doi.org/10.1308/003588414X14055925058959
  • 5. Shimizu S, Uchiyama A, Mizumoto K, et al Lapa¬roscopically assisted distal gastrectomy for early gastric cancer. Is it superior to open surgery? Surg Endosc 2000;14:27–31. https://doi.org/10.1007/s004649900005
  • 6. Lacy AM, Garcia-Valdecasas JC, Delgado S, et al. Laparoscopic-assisted colectomy versus open co¬lectomy for treatment of non-metastatic colon can¬cer: a randomized trial. Lancet 2002;359(9325):2224–9. https://doi.org/10.1016/S0140-6736(02)09290-5
  • 7. Dulucq JL, Wintringer P, Mahajna A. Occult her-nias detected by laparoscopic totally extra-perito-neal inguinal hernia repair: a prospective study. Hernia. 2011;15:399–402. https://doi.org/10.1007/s10029-011-0795-z
  • 8. Koch A, Edwards A, Haapaniemi S, et al. Prospec¬tive evaluation of 6895 groin hernia repairs in women. Br J Surg 2005;92:1553–8. https://doi.org/10.1002/bjs.5156
  • 9. Crawford DL, Hiatt JR, Phillips EH. Laparoscopy identifies unexpected groin hernias. Am Surg. 1998;64:976–8.
  • 10. Henriksen NA, Thorup J, Jorgensen LN. Unsus-pected femoral hernia in patients with a preopera¬tive diagnosis of recurrent inguinal hernia. Hernia. 2012;16:381–5. https://doi.org/10.1007/s10029-012-0924-3
  • 11. Mikkelsen T, Bay-Nielsen M, Kehlet H. Risk of femoral hernia after inguinal herniorrhaphy. Br J Surg. 2002; 89:486–8. https://doi.org/10.1046/j.0007-1323.2002.02058.x
  • 12. Bay-Nielsen M, Kehlet H. Inguinal herniorrhaphy in women. Hernia. 2006;10:30–3. https://doi.org/10.1007/s10029-005-0029-3
  • 13. Simons MP, Aufenacker T, Bay-Nielsen M, et al. European Hernia Society guidelines on the treat-ment of inguinal hernia in adult patients. Hernia. 2009;13:343–403. https://doi.org/10.1007/s10029-009-0529-7
There are 13 citations in total.

Details

Primary Language English
Subjects Surgery
Journal Section Articles
Authors

Şiyar Ersöz 0000-0003-1824-8453

Yasemin Konuk 0000-0002-2618-3349

Deniz Kütük 0000-0002-9084-4869

Akın Fırat Kocaay 0000-0002-6985-910X

Murat Türkeün Ilgınel 0000-0001-9183-9124

Atıl Çakmak 0000-0003-2386-6213

Publication Date April 30, 2023
Acceptance Date March 4, 2023
Published in Issue Year 2023 Volume: 6 Issue: 1

Cite

APA Ersöz, Ş., Konuk, Y., Kütük, D., Kocaay, A. F., et al. (2023). Incidental Femoral Hernias Diagnosed by Laparoscopic Approach: Does Gender Really Matter?. Journal of Cukurova Anesthesia and Surgical Sciences, 6(1), 51-55. https://doi.org/10.36516/jocass.1251912
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