Surg Clin North Am. Dec;78(6) Inguinal hernia repair. The Nyhus posterior preperitoneal operation. Patiño JF(1), García-Herreros LG, Zundel N. A hernia is an outpouching of the parietal peritoneum through a preformed or secondarily established hiatus. If the hernia Table Ib. Nyhus hernia classification. Adapted with permission from Nyhus LM, Klein MS, Rogers FB. Inguinal hernia. Curr Probl Surg ;

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Incisional hernias smaller than 4 cm had a lower risk of recurrence than larger hernias. The techniques in the open anterior repair group differ somewhat in their approach to reconstruction, but they all use permanent sutures to approximate the surrounding fascia and repair the floor of the inguinal canal. Patients with such injuries present with pain in the groin and thigh.

Perineal Hernia Perineal hernias are primary or secondary herniations of the pelvic floor that appear para- or retrorectally between the levator ani and coccygeal muscles. In some series, the recurrence rate following repair of a recurrent hernia is as high as 30 percent, which is significantly greater than the recurrence rate after initial repairs. Incisional or Recurrent Hernia Any recurrent hernia, either inguinal, epigastric, umbilical, or at any other location, must be understood as an incisional hernia.


Nyhus and Condon’s Hernia, 5th Edition

Diagnosis and treatment of genitofemoral and ilioinguinal neuralgia. Recurrence is the most nygus long-term complication of inguinal herniorrhaphy. Total extraperitoneal laparoscopic repair.

More in Pubmed Citation Related Articles. Again, all are very well written and loaded with information regarding repair and management. Literature review and clinical outcome. The larger ones usually readily reducible, whereas the smaller ones often became in-carcerated.

Type I—indirect inguinal hernia.

Pathogenesis The pathogenesis of hernias is multifactorial. A critical evaluation of the Lichtenstein tension-free hernioplasty.

Nyhus and Condon’s Hernia, 5th Edition

A hernia that is not repaired appropriately is more likely to recur. Definition A hernia is an outpouching of the parietal peritoneum through a preformed or secondarily established hiatus.

Hernias may include intra- hwrnia retroperitoneal organs, either permanently or intermittently. There is a male predominance with a male to female ration of at least 3: Laparoscopic techniques make it possible for patients to return to normal activities more quickly, but they are more costly than open procedures.

Address correspondence to Brett C. See My Options close. Compared with other types of hernia repair, laparoscopic herniorrhaphy is significantly more expensive. While these syndromes are often self-limited, surgery nyhud been necessary to remove the staples that caused the neuralgia. The nyhhus of recurrent herniation is generally straightforward.

N Engl J Med. Entrapment of the ilioinguinal nerve produces pain in the groin and scrotum; extension of the hip frequently exacerbates the pain. Laparoscopic herniorrhaphy may be best reserved for treatment of recurrent or bilateral hernias.


The most common hernia in both sexes is the indirect inguinal hernia. If the hernia extends beyond the abdominal cavity and is thus visible on the surface of the body, it is defined as an external hernia. Most inguinal hernia repairs can be performed safely, accurately and cost-effectively using local anesthesia and an open anterior approach.

Nyhus and Condon’s Hernia | JAMA Surgery | JAMA Network

With myhus many techniques available, treatment can be individualized. Variations in the laparoscopic approach to the preperitoneal space and differences in dissection and fixation techniques reflect that the procedure is still evolving, and there is still no consensus on the best laparoscopic herniorrhaphy. Another chapter touches on several up-to-date laparoscopic and endoscopic techniques. The use of alloplastic material leads to an increase of seroma formation, requiring placement of several drainages.

As the majority of these patients have serious underlying problems, a surgical repair is not indicated unless complications, such as incarceration or spontaneous rupture, occur.