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Link to Hernia Anatomy
Mesh Choices for Laparoscopic and Open Ventral Hernia Repair
sageswiki.org
Mesh Confusion: So Many Available, But Which Ones To Use and When?
Jan 2012 General Surgery News
Surgeons Face More Complex Hernias In More Complex Reimbursement World
Jan 2012 General Surgery News
Bilateral Hernias Should Be Repaired Simultaneously, Data Indicate
Jan 2012 General Surgery News
Evidence-based management of post-operative pain in adults undergoing inguinal hernia repair
Sept 2011 British Journal of Surgery
European Hernia Society guidelines on the treatment of inguinal hernia in adult patients
2009 Hernia [Comprehensive article with evidence-based recommendations.]
Some interesting points:
- Watchful waiting is reasonable in any asymptomatic inguinal hernia
- Pre-op antibiotics not recommended
- Activity restrictions recommended only for 2-3 weeks post-op
Guidelines for laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal Hernia
Some highlights:
- Antibiotics – controversial
- Same recurrence rate with or without mesh fixation in TEP
- Less post-op pain and quicker return to function with lap, compared to open
- Chronic pain incidence same for lap or open
- Testicular and ejaculatory pain are more common with lap repair than with open
International guidelines for prevention and management of postoperative chronic pain following inguinal hernia surgeryProvides definitions to better discuss pain and nerve management. Also concludes:
- Incidence of chronic debilitating pain is up to 6%
- Identification and preservation of all three nerves recommended
- Completely remove nerve if in the way of the repair
- Manage pain medically for a year
