Hernia - abnormal protrusion of an organ or tissue through a defect in its surrounding
walls (weakness in the abdominal wall musculature) whatever the type of inguinal hernia, the defect lay in the integrity of the transversalis fascia (concept of placing a Marlex mesh over the entire foor of the inguinal canal) superior to older methods because the weakness of the transversalis fascia can be restored by bridging the defect with a mesh rather than placing tension between tissues to close the defect. laparoscopic inguinal hernia repair - lessens postoperative pain and improves recovery intraperitoneal onlay mesh transabdominal preperitoneal (TAPP) repair totally extraperitoneal (TEP) repair Abdominal wall hernias - occurs only at sites at which the aponeurosis and fascia are not covered by striated muscle. inguinal, femoral, umbilical areas, linea alba, lower portion of the semilunar line, sites of prior incisions groin hernia inguinal hernia indirect direct femoral hernia Neck/orifce of hernia - innermost musculoaponeurotic layer Hernia sac - lined by peritoneum and protrudes from the neck Most inguinal hernia occur on the RIGHT SIDE Signifcant decrease in ratio of type I to type III collagen (does not contribute signifcantly to wound tensile strength as type I) Presumed causes of hernia coughing copd obesity straining (constipation or prostatism) pregnancy birthweight <1500g family history valsalva ascites upright position congenital connective tissue disorders defective collagen synthesis previous RLQ incision arterial aneurysms cigarette smoking heavy lifting physical exertion indirect inguinal and femoral hernia occur more commonly on the right side attribute to the delay in atrophy of the processus vaginalus after the normal slower descent of the right testis to the scrotum during the fetal development predominance of right-sided femoral hernias is thought to be caused by the tamponading efect of the sigmoid colon on the left femoral canal. Strangulated hernia repair of a suspected strangulated hernia is most easily done using a preperitoneal approach. Preperitoneal approach: avoids mobilization of the spermatic cord and injury to the sensory nerves of the inguinal canal, which is particularly important for hernias previously repaired through an anterior approach with this exposure, the hernia sac contents can be directly visualized and their viability assesed through a single incision. the constricting ring is identifed and can be incised to reduce the entrapped viscus with minimal danger to the surrounding oragns, blood vessels, and nerves. if it is necessary to resect strangulated intestine, the peritoneum can be opened and resection done without the need for a 2nd incision.
Biofloc Technology A Review On The Microbial Interactions, Operational Parameters and Implications To Disease and Health Management of Cultured Aquatic Animals