101. Local Anaesthesia For Inguinal And Femoral Hernia Repair (page 1) Advantages, disadvantages, local anaesthetic agents, technique, anatomy, method, complications of local anesthesia in this surgery. http://www.nda.ox.ac.uk/wfsa/html/u04/u04_012.htm

Issue 4 (1994) Article 6: Page 1 of 2 Go to page: 1 Local Anaesthesia for Inguinal and Femoral Hernia Repair Ms J Dunn, Department of Surgery, Bristol Royal Infirmary Dr C J E Day, Department of Anaesthetics, Bristol Royal Infirmary Advantages Anatomy Disadvantages Method ... Technique Introduction Local anaesthesia may be employed in hernia operations, either on its own or combined with general anaesthesia. The choice of technique will be influenced not only by local resources and skills, but also by patient preference. Advantages of Local Anaesthesia for Hernia Repair With a careful technique, local anaesthesia causes minimal physiological disturbance. This may be particularly useful for patients with cardiovascular or respiratory disease for whom there may be advantages in avoiding a general anaesthetic. The absence of postoperative sedation or drowsiness allows early ambulation and diminishes the requirement for recovery facilities. Local anaesthesia provides postoperative analgesia for up to four hours and may be administered by the surgeon. When adrenaline is mixed with the local anaesthetic (normally in a dilution of 1:200,000) useful vasoconstriction is produced resulting in a relatively bloodless field. Disadvantages of Local Anaesthesia for Hernia Repair Surgery on the awake patient under local anaesthesia must be carried out gently. Although pain sensation is usually blocked by the anaesthetic, traction on certain tissues, particularly the peritoneum, is uncomfortable. The patient should be warned that some sensation may be experienced during the operation but that it will not be painful. Larger hernias, particularly those with incarcerated bowel may prove unsuitable for local anaesthesia.

102. Hernia Symptoms And Signs hernia symptoms and signs Inguinal hernia symptoms, Hiatal hernia symptoms, Umbilical hernia symptoms, Disk herniation symptoms. Information On hernia http://herniasymptoms.net/

103. HERNIA SURGERY-TECHNIQUES Contemporary techniques for hernia repair orth P enn H ernia I nstitute 2100 N. Broad St. Lansdale, PA 19446 215368-1122 http://hernia.tripod.com/techcomp.html

N orth P enn H ernia I nstitute 2100 N. Broad St. Lansdale, PA 19446 Fax: NEW PATIENT INFO ADDITIONAL INFORMATION MENU JOIN FREE HERNIA DISCUSSION FORUM MEMBER READ LETTERS FROM PATIENTS AMERICA'S LEADER IN ADVANCED HERNIA SURGERY H ERNIA T ECHNIQUE C OMPARISON Review of Tension Free repair Methods A t the North Penn Hernia Institute, we utilize a mini-incision, TENSION FREE open mesh repair under local anesthesia. Our rate of recurrence with a follow-up of over 10 years with this method is less than 1/2%, the LOWEST recurrence rate of any procedure. A t the North Penn Hernia Institute , the majority of our primary (first time) Inguinal Hernias are repaired using a "tension free" Mesh Technique. We fully feel that this technique is not only the safest procedure available, but also associated with the least post operative discomfort, most rapid return to normal activity and is associated with the lowest rate of recurrence when compared to the other techniques. We do, however, evaluate fully the anatomy of the hernia at the time of surgery. We feel that a single operation is not necessarily suited for all hernias, but that hernias vary from patient to patient. We therefore may on RARE occasion, modify our surgery to provide the patient with what we feel is the best TENSION FREE technique for them. But again, the tension free mesh repair satisfactorily repairs most primary hernias safely and effectively. OLDER SUTURE "TENSION" REPAIRS T raditional ( Tension Repair ) hernia surgery involved cutting adjacent muscle, then pulling it together using sutures or wire. This creates extreme tension on the muscle as it must be moved out of its normal anatomic location to cover the hernia defect. This produces swelling and pain. More importantly, the tension inhibits full and effective healing of the edges. The result of incomplete healing in the presence of this continued tension is the muscle edges may pull apart causing a higher failure rate with recurrent (often larger and more complex) hernia. Also, when the muscle are pulled together adjacent tissue is weakened which too may eventually herniate. Recovery is prolonged with reduced patient flexibility, prolonged pain and restrictions imposed on activity.

104. Local Anesthesia For Inguinal Hernia Repair Anatomy and technique of local anesthesia in repairs of the inguinal defects. http://anesthesiologyinfo.com/articles/04102002.php

Take a look at these features... Before Your Surgery... Anterior Approach to Sciatic Block Frequently Asked Questions Online Childbirth Education Class Don't miss these other areas of the site: Two years of articles sorted by topic area A statement about dead links on this site Subscribe to the site newsletter Information on current sponsors and how to sponsor this site Local Anesthesia for Inguinal Hernia Repair (Originally posted 22 September 1997 on About Anesthesiology) INTRODUCTION Many practitioners and institutions routinely and successfully employ local anesthesia for inguinal hernia repairs. Although there are certainly other options (including general anesthesia and regionl anesthesia such as spinal or epidural), local offers some unique advantages to the patient. As such, here is a short summary about the use of local for these operations including a discusssion of advantages and disadvantages. Obviously, the choice of anesthesia will be influenced by patient preferences and needs. In addition, to complete any operation successfully under local anesthesia requires a surgeon who is comfortable with the technique and willing to stop surgery and place additional local anesthesia should this become necessary. Interestingly with inguinal hernia repair it is rarely, if ever, necessary to supplement with additional injections once the initial infiltration is complete. Reported experiences with it have been uniformly positive. Advantages of Local Anesthesia Minimal physiological disturbance which may be an advantage in the patient in whom you wish to avoid a general anesthetic and in whom a regional technique may be contraindicated. This could include patient's with serious cardiac or respiratory diseases which could tolerate other types of anesthesia but would be at reduced risk if given only local anesthesia.

105. Hernia - Symptoms, Diagnosis, Treatment Of Hernia - NY Times Health Information Dec 13, 2009 A hernia is usually a sac formed by the lining of the abdominal cavity ( peritoneum). The sac comes through a hole or weak area in the fascia http://health.nytimes.com/health/guides/disease/hernia/overview.html

106. Surgical Options In The Management Of Groin Hernias - January 1, 1999 - American Epidemiology, anatomy, diagnosis, classification, indications to surgery, anesthesia, techniques and results, in a scientific paper provided by American Academy of Family Physicians. http://www.aafp.org/afp/990101ap/143.html

Advertisement Home Page Journals Advanced Search Please note: The American Family Physician Web archive extends from 1998 to the present. Enhanced features are available for content published after 2000. (Corrections made to Figs. 1, 2, 3, 4, and 8 in this article on February 17, 1999.) Surgical Options in the Management of Groin Hernias TIM BAX, M.D., BRETT C. SHEPPARD, M.D., and RICHARD A. CRASS, M.D. Oregon Health Sciences University, Portland, Oregon I nguinal and femoral hernias are the most common problems primary care physicians encounter that require surgical intervention. The treatment of these hernias costs approximately $3.5 billion every year. Untreated or recurrent inguinal hernias are responsible for an incalculable loss of productivity and revenue. Postoperative convalescence also contributes to absence from the work force. A clear understanding of the epidemiology and anatomy of inguinal hernias provides a solid foundation for timely diagnosis and care. Since inguinal herniorrhaphy can be performed using a variety of techniques, the approach can be individualized. This article reviews the available surgical options for herniorrhaphy and the possible complications of these procedures. Epidemiology In the United States, approximately 96 percent of groin hernias are inguinal and 4 percent are femoral. Inguinal hernias are bilateral in as many as 20 percent of affected adults.

107. Abdominal Hernias: EMedicine General Surgery A hernia of Cloquet results from an abnormal insertion of the pectineus muscle, which allows perforation of the aponeurosis as the hernia sac courses over the femoral canal. http://emedicine.medscape.com/article/189563-overview

108. Laparoscopic Repair Of Inguinal & Femoral Hernias Technical manual providing information about anatomy, repair techniques, post-operative instructions, management of complications of laparoscopic treatment of inguinal and femoral defects. http://www.laparoscopy.net/inguinal/ingher1.htm

Laparoscopic Inguinal Hernia Repair Table of Contents Overview Laparoscopic Anatomy Technical Analysis and Laparoscopic Mesh The Instruments Operating Room Set-up Trocars Placement ... References Procedural Videos

109. Great Lakes Hernia Center Inc. Information about the Center and procedures performed, frequently asked questions, insurance information and an online consult. Located in Sylvania, Ohio http://www.greatlakeshernia.com/

110. Sports Hernia And Sports Hernias - William Brown, MD A sports hernia is probably the least understood of the injuries that involve athletes. Dr. Willam Brown is an authority on sports hernia and the treatment http://www.sportshernia.com/

contact home Your Guide to Sports Hernias and the Medical Treatment of Sports Hernias by Dr. William Brown, MD What is a Hernia Our Approach Overview Physical Exam ... Contact Understanding the Often Misunderstood and Misdiagnosed Sports Hernia A sports hernia is probably the least understood of all the injuries that involve professional level and collegiate level athletes. A sports hernia is a tear to the oblique abdominal muscles. Unlike a traditional hernia, the sports hernia does not create a hole in abdominal wall. As a result, there is no visible bulge under the skin. This means making a definitive sports hernia diagnosis is difficult. It is not uncommon for one of Dr. Brown's patients to have seen four or five other consultants prior to seeing him. The athlete is often given the diagnosis of a groin strain and is told to rest and that the problem will go away. And it does for a while, but the pain associated with a true sports hernia will return with a vengeance once the ibuprofen wears off and activity resumes. Failing to understand the underlying issues surrounding sports hernias results in chronic pain for the athlete and an unnecessary delay in diagnosis and treatment. Any athlete who suffers chronic groin pain that is aggravated by sports and is relieved by rest should be strongly considered to have a sports hernia.

111. Welcome To The Hernia Center Information for patients waiting for operation. Email contact with specialists, phone and address. Located in St. Petersbourg, Florida. http://www.herniasurgery.com

Definition Cost Fly / Fix Program Return To Work ... Questions / Comments Addition Information: For a Patient with a Hernia Contact Us

112. Hiatal Hernia achalasia surgery Cleveland Clinic Thoracic Surgery - renowned thoracic surgeons offer world class minimally invasive thoracic surgery for achalasia, http://my.clevelandclinic.org/disorders/hiatal_hernia/ts_overview.aspx

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113. Hernia Clinic The Navjeevan Hospital offers information about symptoms and FAQs, phone contact and mail form to consult a doctor. Located in the North-East part of Mumbai - India. http://www.herniahelpclinic.com/

Contact Us Site Map About Hernia Hernia is a very common disorder and affects about 2% of the population; hence it is important for. More Common Symptoms of Hernia Swelling increases in size on lifting heavy weight,coughing, sneezing or... More FAQ Do hernias usually develope on both sides of the body? More Home Navjeevan Hospital Case Studies ... Site Map

114. Scottish Hernia Centre Information about diagnosis and treatment of the disease, scientific activity of the centre, FAQs. Contact by mail, email, phone and fax. http://www.scottishherniacentre.co.uk/

115. Fetal Care Center Of Cincinnati The Fetal Care Center of Cincinnati provides information and illustrations. http://www.fetalcarecenter.org/medicine/therapies/cdh/

Fetal Care Center of Cincinnati Fetal Conditions Fetal Surgery Services ... Contact Us Fetal Care Center of Cincinnati 2009 Advances in Fetology Conference Get access to archived presentations for continuing education credit Cincinnati Children's - Good Samaritan - University Hospital The Fetal Care Center of Cincinnati provides excellent, comprehensive maternal fetal health services for high-risk pregnancy patients renowned physicians, comprehensive services, advanced technologies and comforting support all in a single, family-oriented center. The Center offers a complete range of services, from prenatal diagnosis through fetal interventions , including open fetal surgery Affiliated with two Level III maternity hospitals and three Level III Neonatal Intensive Care Units, the Fetal Care Center of Cincinnati features experienced maternal, fetal and pediatric specialists, who work closely with mothers and families, answering questions, offering support and counseling and providing the most advanced options for care and treatment. Fetal Surgery Unit Tour the fetal surgery unit , the first inpatient and outpatient unit in the world specifically designed and dedicated to fetal surgery patients, and learn more about how the facility caters to the medical, surgical and emotional needs of mothers and their families.Â

116. Hernia hernia hernia was founded in 1997 with the purpose of promoting clinical studies and basic research as they apply to groin hernias, internal hernias, http://www.springer.com/medicine/surgery/journal/10029

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117. Combined Faschia And Mesh Closure A method for closing large midline incisional hernias using both the fascia and a mesh. Scientific paper by The Royal College of Surgeons of Edinburgh. http://www.rcsed.ac.uk/journal/vol43_1/4310010.htm

J.R.Coll. Surg. Edinb. , February 1998,29-30 Surgical technique section Combined fascia and mesh closure of large incisional hernias M. S. WHITELEY, S. B. RAY-CHAUDHURI AND R. B. GALLAND Department of Surgery, Royal Berkshire Hospital, Reading, UK Large incisional hernias of the abdominal wall represent substantial defects of supportive tissues. The repair of these requires the mobilization of fascia or the use of a prosthetic mesh. A method for closing large midline incisional hernias using both the fascia and a mesh was described in 1979. This repair was used for six midline hernias and four large incisional hernias in the right subcostal region. No wound complications and no recurrences (median follow-up 1 year 5 months) were seen. The combined fascia and mesh repair can be successfully used for large incisional hernias of the anterior abdominal wall in areas other than the midline. Keywords: incisional hernias, prosthetic mesh. Incisional hernias develop in up to 11% of surgical abdominal wounds. Recurrence after repair has been described in up to 44% of patients.

118. YourSurgery.Com®-Hernia // /script Script Type= Text A hernia is a protrusion of usually a loop of bowel or a tissue through an opening in the wall of the abdominal cavity in which the bowel lies. http://yoursurgery.com/ProcedureDetails.cfm?BR=1&Proc=26

119. Repair Of Incisional Hernias A scientific report concerning surgical mesh repair of abdominal wall defect, results and discussion about them. http://www.rcsed.ac.uk/journal/vol46_1/4610007.htm

Repair of incisional hernias H.S. KHAIRA, P. LALL, B. HUNTER and J.H. BROWN Department of Surgery, Good Hope Hospital NHS Trust, Sutton Coldfield,U.K. Introduction Method and patients Results Discussion ... References 6.2 days. Of the 35 patients 33 were available for follow-up. Follow-up was for a median of 20.3 months (range 6.0 to 54.1 months). Two of these (6%) patients reported a persistent lump and one (3%) reported persistent pain but none of the remaining 33 was found to have a recurrence. We advocate this technique because it is applicable to all hernias, most of the mesh is behind the rectus sheath and has 2 points of fixation, it is relatively pain-free allowing early mobilisation, has a modest complication rate and a low recurrence rate. Keywords: incisional hernia, prosthetic mesh J.R.Coll.Surg.Edinb., 46, February 2001, 39-43 INTRODUCTION Incisional hernias develop in 3.8-11.5 % of patients after abdominal surgery. The incidence depends on a number of factors including old age, male sex, obesity, bowel surgery, suture type, chest infection, abdominal distension and wound infection.1 Ninety percent of incisional hernias occur within 3 years of operation. Repair of large abdominal incisional hernias is a difficult surgical problem with recurrence being a common outcome. Recurrence rates of up to 33% after first repair and 44% after second repair have been reported

120. Congenital Diaphragmatic Hernia (CDH) | UCSF Fetal Treatment Center Aug 26, 2010 Information about diagnosis and treatment of Congenital Diaphragmatic hernia from the UCSF Fetal Treatment Center. http://fetus.ucsfmedicalcenter.org/cdh/

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