General Surgery Chapter 14 Hernias (Nicola)

Helpfulness: 0
Set Details Share
created 6 years ago by fudgey65
582 views
updated 6 years ago by fudgey65
Subjects:
medical, surgery
show moreless
Page to share:
Embed this setcancel
COPY
code changes based on your size selection
Size:
X
Show:
1

Latin for “rupture” and is defined as a protrusion of a viscus through an opening in the wall of the cavity in which it is contained

Hernia

2

What is the defect in the abdominal wall

card image

Hernial orifice

3

What is the is the outpouching of the peritoneum

card image

Hernia sac

4

What may be congenital, acquired, or a combination thereof.

A hernia

5

What features of the abdomen and the various types of pathology result in several different but recognizable types of hernia

Anatomical

6

What are the 4 categories of hernias
Features referred to as anatomical locations

Groin
Ventral
Incisional
Diaphragmatic

7

Anatomical/Category of hernia:
Hernias of the inguinal and femoral areas

card image

Groin Hernia

8

Anatomical/Category of hernia:
Present on the anterior abdominal wall at any point other than the groin

card image

Ventral Hernia

9

Anatomical/Category of hernia:
Hernias at sites of previous surgery and at stomal sites

card image

Incisional Hernia

10

Anatomical/Category of hernia:
Hernias in the diaphragm, usually at the esophageal hiatus

card image

Diaphragmatic Hernia

Image is a bilateral Diaphragmatic Hernia

11

Anatomical/Category of hernia:
Inguinal: above the abdominocrural crease
Can be direct or indirect
Requires a penrose drain, either 1/2" or 1", to isolate the spermatic cord

Groin hernia
Typical in males

12

Anatomical/Category of hernia:
Femoral: below the abdominocrural crease
Typical in females due to pregnancy

Groin hernia
Typical in females

13

Anatomical/Category of hernia:
What may present along the linea alba (epigastric, umbilical, and hypogastric) or at the semilunar lines (Spigelian hernia)

Ventral Hernia

14

Condition/Type of hernia:
Manual manipulation can return the hernia contents to the abdominal cavity

Reducible Hernia

15

Condition/Type of hernia:
Cannot be manipulated
Can be visible (external) or invisible (internal)
Can be painful to manipulate

card image

Irreducible or incarcerated Hernia

16

Condition/Type of hernia:
Hernia with luminal viscera entrapment that compromises the vascularity of the viscera

card image

Strangulated Hernia

17

Condition/Type of hernia:
Incarcerated or strangulated bowel spontaneously reduces and the subsequent gangrenous (like a blister) portion of bowel may be overlooked during hernia repair

card image

Richter’s Hernia

18

Condition/Type of hernia:
The abdominal viscera forms part of the hernia sac

Sliding Hernia

19

Condition/Type of hernia:
Acquired type of hernia by job, sports, activity

card image

Direct Hernia

20

Condition/Type of hernia:
Inguinal Hernia
Acquired type

card image

Direct Hernia

21

Condition/Type of hernia:
Presents within Hesselbach’s triangle (bounded by the inguinal ligament, the inferior epigastric vessels, and the lateral border of the rectus abdominis) and acquired

card image

Direct Hernia

22

Condition/Type of hernia:
Inguinal hernia
Congenital type

card image

Indirect Hernia

23

Condition/Type of hernia:
Congenital type defects that dilate the internal inguinal ring and pass through the deep inguinal ring to the scrotum

Hernia sac is generally confined to the spermatic cord and the posterior inguinal wall remains intact

card image

Indirect Hernia

24

Condition/Type of hernia:
Both direct and indirect hernias are present

card image

Pantaloon Hernia

25

Condition/Type of hernia:
More typical in females
The hernia sac originates from the femoral canal through a defect in the medial femoral sheath and emerges through the fossa ovalis of the pelvis into the subcutaneous tissues of the thigh, inferior to the inguinal ligament.

card image

Femoral Hernia

26

Condition/Type of hernia:
Midline hernias above the umbilicus

Epigastric Hernia

27

Condition/Type of hernia:
Midline hernias below the umbilicus

Hypogastric Hernia

28

Condition/Type of hernia:
In children: usually congenital; often spontaneously close

card image

Umbilical Hernia

29

Condition/Type of hernia:
In adults: usually acquired
Hernia consists of a peritoneal sac (or sacs) and omentum or abdominal viscera contents protruding through the umbilical ring

card image

Umbilical Hernia

30

What are the most commonly used hernia materials in the OR

Vicrly (poly 910)
Prolene
Bovene products

31

What mesh can be used for femoral and inguinal hernias, they have three points of protection Parts: Onlay patch, connector, and underlay patch5
Don't need suture but some surgeons will suture them in place

card image

Self retaining mesh

32

What mesh can be used for umbilical hernias, and obese patients. They have a tail to help manipulate into place

card image

Ventral Patch

33

What mesh can be used:
- in males to isolate the spermatic cord
- in male and female to strengthen the abdominal wall (flower)

card image

Hernia plug, flower, mesh

34

What mesh can be cut to fit any sized hernia repair, and must be opened, preferably kept in water to prevent it from returning to its previous state allowing quicker installation

card image

Suture pads, meshes, patches

35

What device is used to secure hernia mesh in the abdominal cavity

card image

Protack Autosuture Device

36

What would use this setup?
#15 blade
12mm Trocar
5mm Trocar x2
10mm Trocar with video and insufflation for umbilicus

Laparoscopic Hernia

37

What is one of the most common laparoscopic techniques for inguinal hernia repair

Totally extraperitoneal repair (TEP)

38

What is anything that uses a patch, film or mesh

Totally extraperitoneal repair (TEP)

39

What would use a universal drape pack, 4 towels, and a transverse lap drape.

Ventral (Incisional) Hernia

40

What case would you want to have a open bowel tray on stand by incase it turned into an open case

Ventral (Incisional) Hernia

41

What case do you have to perform an instrument count for

Ventral (Incisional) Hernia

42

What case requires a #10 blade and allis clamps to remove old scar tissue

Ventral (Incisional) Hernia