Hernia Orophy



  1. Ventral Herniorrhaphy
  2. Herniaorthy
Dr Yuranga Weerakkody and Assoc Prof Frank Gaillard et al.

Abdominal hernias (herniae also used) may be congenital or acquired and come with varying eponyms. They are distinguished primarily based on location and content. 75-80% of all hernias are inguinal.

Content of the hernia is variable, and may include:

  • small bowel loops
  • mobile colon segments (sigmoid, cecum, appendix)
  • mesenteric fat
  • other viscera

Complications predominantly relate to bowel incarceration, strangulation, and intestinal obstruction. Large diaphragmatic hernias in infancy may be complicated by pulmonary hypoplasia.

Ventral Herniorrhaphy

  1. Inguinal hernia What is a hernia? A hernia is a common condition that occurs when part of an internal organ or tissue bulges through a muscle. Hernias can occur around the belly button, through a surgical scar, in the diaphragm, or in the groin (the area between the abdomen and the thigh on both sides of the body).
  2. What is Herniorrhaphy? Herniorrhaphy is the surgical operation done to repair an indirect or direct inguinal hernia. Herniorrhaphy procedures can be performed by an open technique or a laparoscopic technique. Back to the top.
Classification
  1. external herniation
    • ventral: anterior and lateral abdominal hernias
    • dorsal
    • groin: most common
  2. diaphragmatic herniation
  3. internal herniation
Subclassification
  • anterior abdominal wall herniation
    • rectus sheath - rectus sheath hernia
    • miscellaneous
      • Richter hernia: contains only one wall of a bowel loop
  • lumbar herniation
  • groin herniation
    • inguinal hernia
      • indirect inguinal hernia: five times commoner than direct
      • pantaloon hernia (combined direct and indirect inguinal herniae)
    • femoral hernia
  • diaphragmatic herniation
  • internal herniation: an uncommon cause of bowel obstruction
    • the left paraduodenal fossa (fossa of Landzert): most common
    • the right paraduodenal fossa (fossa of Waldyer)
    • the foramen of Winslow (lesser sac)
    • a hole in the mesentery (transmesenteric)
    • a hole in the transverse mesocolon
    • a defect in the broad ligament
    • the superior ileocecal fossa
    • the inferior ileocecal fossa
    • the retrocecal fossa
  • Littre hernia: hernia containing a Meckel diverticulum
  • pelvic hernia
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A hernia occurs when fatty tissue or an organ pushes through a weak place in the surrounding connective tissue or muscle wall. Hernias usually don’t get better on their own. They tend to get. In this surgical procedure, also known as herniorrhaphy, the surgeon makes an incision in the abdomen above the hernia, pushes any protruding intestine back into the abdomen and repairs the opening in the muscle wall. Sometimes, in a procedure known as hernioplasty, the weak area is repaired and reinforced with steel mesh or wire. A herniorrhaphy refers to the surgical repair of a hernia, in which a surgeon repairs the weakness in your abdominal wall. A hernia occurs when a weak area in the muscles of your abdominal wall.

Herniaorthy

  • 1. Aguirre DA, Casola G, Sirlin C. Abdominal wall hernias: MDCT findings. AJR Am J Roentgenol. 2004;183 (3): 681-90. AJR Am J Roentgenol (full text) - Pubmed citation
  • 2. Ianora AA, Midiri M, Vinci R et-al. Abdominal wall hernias: imaging with spiral CT. Eur Radiol. 2000;10 (6): 914-9. Eur Radiol (link) - Pubmed citation
  • 3. Wechsler RJ, Kurtz AB, Needleman L et-al. Cross-sectional imaging of abdominal wall hernias. AJR Am J Roentgenol. 1989;153 (3): 517-21. AJR Am J Roentgenol (citation) - Pubmed citation
  • 4. Miller PA, Mezwa DG, Feczko PJ et-al. Imaging of abdominal hernias. Radiographics. 1995;15 (2): 333-47. Radiographics (abstract) - Pubmed citation
  • 5. Doishita S, Takeshita T, Uchima Y et-al. Internal Hernias in the Era of Multidetector CT: Correlation of Imaging and Surgical Findings. Radiographics. 2016;36 (1): 88-106. doi:10.1148/rg.2016150113 - Pubmed citation
  • 6. Lassandro, Francesco, et al. 'Abdominal hernias: Radiological features.' World journal of gastrointestinal endoscopy 3.6 (2011): 110. Pubmed citation
  • 7. Miguel C. Cabarrus, Benjamin M. Yeh, Andrew S. Phelps, et al. From Inguinal Hernias to Spermatic Cord Lipomas: Pearls, Pitfalls, and Mimics of Abdominal and Pelvic Hernias. (2017) RadioGraphics. 37 (7): 2063-2082. doi:10.1148/rg.2017170070 - Pubmed

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Today one of the PG trainee of our General Surgery team was telling the assistant professor about the procedure he performed on some specific patient who needed hernial repair.

While doing that, he mixed the terms herniorrhaphy and hernioplasty! The asst. professor asked him to explain herniorraphy vs hernioplasty, he got confused! What an embarrassment!

Anyway to save all of us from this situation in future, lets see what’s the difference between herniorraphy and hernioplasty.

Difference between herniorrhaphy and hernioplasty

Well I won’t be going into the details of herniorrhaphy or hernioplasty here though but will simply like to tell you the difference between the two and how to remember it.

What is meant by herniorrhaphy?

Herniorrhaphy = repairing the defect by stitching the healthy ends of tissue or muscle together.

This procedure doesn’t involve using a mesh. It’s a simple repair in the defect of the wall (abdominal wall for example) resulting in the herniation.

Hernia physical exam

It’s also spelled (or misspelled) as: herniorraphy and hernioraphy.

What is meant by hernioplasty?

Hernioplasty = repairing the defect using mesh patches.

This process involves repairing the wall through which herniation is occurring, using a mesh patch.

How to remember it ? well if the original tissue is Repaired (R) then it’s hernioRrhaphy and if a mesh Patch is applied then its hernioPlasty.

Hope it will help you remember the difference between herniorrhaphy and hernioplasty!

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