CHAPTER 12 Abdominal wall and hernia
Herniae
Reducible hernia
This is one in which the contents of the sac reduce spontaneously or can be pushed back manually.
Classification of hernia
Types of hernia
Inguinal hernia
This is the most common form of hernia. There are two types: indirect and direct.
Direct
Both types may occur and straddle the inferior epigastric artery, the so-called ‘pantaloon’ hernia.
Treatment
Uncomplicated
2. Shouldice repair – this is a double-breasted repair of the transversalis fascia followed by suturing of the conjoint tendon to the inguinal ligament with non-absorbable sutures.
3. Laparoscopic – this may be via an extraperitoneal or intraperitoneal technique. NICE guidelines recommend this technique for bilateral or recurrent inguinal herniae.