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  • Hernias

    Inguinal Hernias

    The fellow should be able to:

    • Demonstrate an understanding of the management of inguinal hernia (including femoral) in the acute setting
    • Describe the role of hernia reduction in the management of hernia disease
    • Understand the indications for emergent surgery in inguinal hernias
    • Describe the controversy of mesh vs tissue repair in the presence of contamination
    • Describe the tissue repair options for inguinal hernia repair
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    Ventral/Incisional Hernias

    The fellow should be able to:

    • Demonstrate an understanding of the management of ventral/incisional hernias in the acute setting
    • Describe the role of hernia reduction in the management of ventral hernias
    • Understand the indications for emergent surgery in ventral hernias
    • Describe the surgical options for emergent ventral hernia repair including minimally invasive techniques
    • Describe the controversy of mesh vs tissue repair in the presence of contamination
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    Parastomal Hernias

    The fellow should be able to:

    • Demonstrate an understanding of the management of parastomal hernias in the acute setting
    • Understand the indications for emergent surgery in parastomal hernias
    • Describe the surgical options for emergent parastomal hernia repair including minimally invasive techniques
    • Describe the controversy of relocating the ostomy vs primary repair vs mesh repair
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    Unusual Hernias

    The fellow should be able to:

    • Demonstrate an understanding of the management of Spigelian hernias in the acute setting
    • Demonstrate an understanding of the management of diaphragmatic hernias in the acute setting
    • Demonstrate an understanding of the management of obturator hernias in the acute setting
    • Describe the surgical options for Spigelian, diaphragmatic, and obturator hernia repairs including minimally invasive techniques
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    Resources

    • Topic Summary
    • AAST Education Module - Unusual Hernias
    • Additional Resources:
      • Chen J, Glasgow RE. What is the Best Inguinal Hernia Repair? Adv Surg. 2022;56(1):247-58.
      • de Goede B, Wijsmuller AR, van Ramshorst GH, van Kempen BJ, Hop WCJ, Klitsie PJ, Scheltinga MR, de Haan J, Mastboom WJB, van der Harst E, et al. Watchful Waiting Versus Surgery of Mildly Symptomatic or Asymptomatic Inguinal Hernia in Men Aged 50 Years and Older: A Randomized Controlled Trial. Ann Surg. 2018;267(1):42-9.
      • Fitzgibbons RJ, Jr., Giobbie-Hurder A, Gibbs JO, Dunlop DD, Reda DJ, McCarthy M, Jr., Neumayer LA, Barkun JS, Hoehn JL, Murphy JT, et al. Watchful waiting vs repair of inguinal hernia in minimally symptomatic men: a randomized clinical trial. JAMA. 2006;295(3):285-92.
      • Haladu N, Alabi A, Brazzelli M, Imamura M, Ahmed I, Ramsay G, Scott NW. Open versus laparoscopic repair of inguinal hernia: an overview of systematic reviews of randomised controlled trials. Surg Endosc. 2022;36(7):4685-700.
      • HerniaSurge G. International guidelines for groin hernia management. Hernia. 2018;22(1):1-165.
      • Meier J, Stevens A, Berger M, Makris KI, Bramos A, Reisch J, Cullum CM, Lee SC, Sugg Skinner C, Zeh H, et al. Comparison of Postoperative Outcomes of Laparoscopic vs Open Inguinal Hernia Repair. JAMA Surg. 2023;158(2):172-80.
      • Bougard H, Coolen D, de Beer R, Folscher D, Kloppers J, Koto M, Reimers G, Sofianos C, Oodit R. HIG (SA) Guidelines for the Management of Ventral Hernias. South African Journal of Surgery. 2016;54:s1-s32.
      • Hanzalova I, Schafer M, Demartines N, Clerc D. Spigelian hernia: current approaches to surgical treatment-a review. Hernia. 2022;26(6):1427-33.
      • Henriksen NA, Montgomery A, Kaufmann R, Berrevoet F, East B, Fischer J, Hope W, Klassen D, Lorenz R, Renard Y, et al. Guidelines for treatment of umbilical and epigastric hernias from the European Hernia Society and Americas Hernia Society. Br J Surg. 2020;107(3):171-90.
      • European Hernia Society guidelines on prevention and treatment of parastomal hernias10. Antoniu SA, Agresta F, Garcia Alamino JM, et al. European Hernia Society guidelines on prevention and treatment of parastomal hernias. Hernia 2018;22(1):183-198
      • Rendell VR, Pauli EM. Parastomal hernia repair. Surg Clin North Am 2023;103(5):993-1010
      • Wilson MZ, Winder JS, Pauli EM. Open parastomal hernia repair. In: Novitsky Y (Eds) Hernia Surgery. Springer, Cham
      • Hajibandeh S, Hajibandeh S, Abdelkarim M et al. Closure versus non-closure of mesenteric defects in laparoscopic Roux-en-Y gastric bypass: a systematic review and meta-analysis. Surg Endosc 2020;34(8):3306-3320.
      • Al Nawas M, Oor JE, Goense L et al. The diagnostic accuracy of abdominal computed tomography in diagnosing internal herniation following Roux-en-Y gastric bypass surgery: A systematic review and meta-analysis. Ann Surg 2022;275(5):856-863
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