Herniorrhaphy (Hernioplasty, Hernia repair) is a surgical procedure for correcting
hernia. A hernia is a bulging of
internal organs or
tissues, which protrude through an abnormal opening in the muscle wall. Hernias can occur in the
abdomen,
groin, and at the site of a previous surgery. Herniorraphy, or hernioplasty, is now often performed as an ambulatory, or "day surgery," procedure. Almost 700,000 are performed each year in the United States. A workable technique of repairing hernia was first described by Bassini in the 1800s; the Bassini technique was a "tension" repair, in which the edges of the defect are sewn back together without any reinforcement or prosthesis. In the Bassini technique, the
conjoint tendon (formed by the distal ends of the
transversus abdominis muscle and the
internal oblique muscle) is approximated to the
inguinal canal and closed. Although tension repairs are no longer the standard of care due to the high rate of recurrence of the hernia, long recovery period, and post-operative pain, a few tension repairs are still in use today; these include the Shouldice and the Cooper's Ligament/McVay repair. The Shouldice techniques is a complicated four layer reconstruction, however, it has very low reported recurrence rates (1%). An operation in which the hernia sac is removed in addition to tension repair is described as a 'herniotomy'.
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