Femoral hernia surgery
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Femoral hernia Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Femoral hernia surgery On the Web |
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American Roentgen Ray Society Images of Femoral hernia surgery |
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Risk calculators and risk factors for Femoral hernia surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Femoral hernias like most other hernias need operative intervention. This should ideally be done as an elective procedure. However, because of the high incidence of complications femoral hernias often need emergency surgery.
Surgery
Surgery may be performed under general or regional anaesthesia. Three approaches have been described.
- Lockwood’s infra-inguinal approach
- Lotheissen‘s trans-inguinal approach
- McEvedy’s high approach
The infra-inguinal approach is the preferred method for elective repair. The trans-inguinal approach involves dissecting through the inguinal canal and carries the risk of weakening the inguinal canal. McEvedy’s approach is preferred in the emergency setting when strangulation is suspected. This allows better access to and visualisation of bowel for possible resection. In any approach care should be taken to avoid injury to the urinary bladder which is often a part of the medial part of the hernial sac.
Repair is either performed by suturing the inguinal ligament to the pectineal ligament using strong non-absorbable sutures or by placing a mesh plug in the femoral ring. With either technique care should be taken to avoid any pressure on the femoral vein.
Postoperative Outcome
Patients undergoing elective repair do very well and may be able to go home the same day. However, emergency repair carries a greater morbidity and mortality rate and this is directly proportional to the degree of bowel compromise. Patient's other co-existing medical conditions also influence outcome.