Inguinal Hernia (Direct Inguinal Hernia)

An abdominal hernia with an external bulge in the GROIN region. It can be classified by the location of herniation. Indirect inguinal hernias occur through the internal inguinal ring. Direct inguinal hernias occur through defects in the ABDOMINAL WALL (transversalis fascia) in Hesselbach's triangle. The former type is commonly seen in children and young adults; the latter in adults.

Also Known As:

Networked: 2451 relevant articles (128 outcomes, 388 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Hernia (Hernias)
2.	Postoperative Pain
3.	Pain (Aches)
4.	Infection
5.	Inguinal Hernia (Direct Inguinal Hernia)

Experts

1.	Bittner, R: 14 articles (12/2015 - 03/2000)
2.	Köckerling, F: 13 articles (12/2015 - 02/2003)
3.	Klinge, U: 11 articles (06/2015 - 01/2000)
4.	Lau, Hung: 11 articles (01/2006 - 10/2002)
5.	Schumpelick, V: 9 articles (04/2014 - 01/2000)
6.	Nixon, S J: 9 articles (02/2010 - 04/2000)
7.	Miserez, M: 8 articles (10/2014 - 04/2008)
8.	Hur, Kyung Yul: 8 articles (06/2013 - 07/2010)
9.	Choi, Yoon Young: 8 articles (06/2013 - 07/2010)
10.	Rosenberg, J: 7 articles (06/2015 - 04/2008)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Inguinal Hernia:

1.	tetraethylpyrazine (TEP)IBA 12/01/2001 - "The use of laparoscopic TEP repair has proven to be a safe and effective treatment in patients with primary and recurrent inguinal hernias. " 06/01/2015 - "Laparoscopic TEP inguinal hernia repair can be further improved with surgical proficiency and high surgical volumes." 03/01/2006 - "Laparoscopic TEP for inguinal hernia repair in patients after previous low abdominal surgery has good results, similar to those in patients without previous surgery. " 07/01/2010 - "Many studies have reported that laparoscopic total extraperitoneal (TEP) repair for recurrent inguinal hernia after an open hernioplasty was safe and effective. " 01/01/2013 - "Relaparoscopic repair appears to be safe and effective in the treatment of recurrent inguinal hernia and repeated TEP could be a simpler approach than expected in the presence of no prior mesh fixation. "
2.	tetra-4-amidinophenoxypropane (TAPP)IBA 04/01/2007 - "Given the unique ability of laparoscopy to accurately evaluate the contralateral side and the limited added morbidity of bilateral repair, TAPP herniorrhaphy is beneficial in avoiding unnecessary explorations and allowing timely repairs in patients with occult inguinal hernias." 06/01/2000 - "The TAPP method appears to be an effective surgical alternative in patients with inguinal hernia." 11/01/2001 - "TAPP is safe and effective for the repair of the bilateral inguinal hernias." 07/01/2015 - "In recent years, 2 modifications of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair-needlescopic (nTAPP) surgery and single-port (sTAPP) surgery-have greatly improved patient outcomes over traditional approaches. " 04/01/2015 - "Comparison of postoperative short-term complications after laparoscopic transabdominal preperitoneal (TAPP) versus Lichtenstein tension free inguinal hernia repair: a randomized trial study."
3.	Polypropylenes (Polypropylene)IBA 06/01/2005 - "Prolene Darn: safe and effective method for primary inguinal hernia repair." 04/01/2014 - "A prospective, randomized, double-blinded, single-center trial was conducted to evaluate the efficacy of a biologic Inguinal Hernia Matrix (IHM; Cook Medical) compared with polypropylene (PP) mesh using Lichtenstein's inguinal hernia repair in a 3-year outcomes study. " 09/01/2009 - "The aim of this study was to evaluate the safety and efficacy of Lichtenstein's hernioplasty using Surgisis Inguinal Hernia Matrix (SIHM; Cook, Bloomington, Indiana) compared with polypropylene (PP; Angiologica, Pavia, Italy). " 06/01/2015 - "We conducted a prospective, sequenced, non-randomized study comprising 38 patients undergoing inguinal hernia repair with placement of polypropylene mesh. " 01/01/2015 - "A systematic review and meta-analysis was performed in randomized controlled trials (RCTs) to compare porcine small intestinal submucosa (SIS) with polypropylene in open inguinal hernia repair. "
4.	Bupivacaine (Bupivacaine Hydrochloride)FDA LinkGeneric 01/01/2003 - "Randomized clinical trial of postoperative subfascial infusion with bupivacaine following ambulatory open mesh repair of inguinal hernia." 01/01/1995 - "A 50-year-old man had an inguinal hernia repair under spinal anaesthesia with bupivacaine. " 04/01/2014 - "Effect of extraperitoneal bupivacaine analgesia in laparoscopic inguinal hernia repair: a meta-analysis of randomized controlled trials." 08/01/2013 - "In this randomized clinical trial, local infiltration of bupivacaine in patients undergoing inguinal hernia repair under spinal anesthesia was compared with placebo. " 03/01/2013 - "Caudal bupivacaine is widely used for inguinal hernia repair in children, but often cannot totally eliminate responses to hernial sac traction. "
5.	KetorolacIBA 05/01/1997 - "Ketorolac provides enhanced patient comfort when it is administered in the surgical site in patients undergoing inguinal hernia repair. " 06/01/2005 - "Ketorolac analgesia for inguinal hernia repair is not improved by peripheral administration." 09/01/1997 - "The use of intravenous ketorolac to supplement local anesthesia infiltrated by the surgeon during pediatric inguinal hernia repair is superior to supplementation with caudal analgesia." 09/01/1997 - "This study compared the analgesic efficacy, adverse events, and the costs associated with supplementation of local anesthesia (infiltration of the wound) with either intravenous ketorolac or caudal analgesia in children having inguinal hernia repair. " 10/01/2002 - "The present prospective randomized trial was undertaken to compare the efficacy of intravenous ketorolac and rectal diclofenac for ambulatory inguinal hernia repairs. "
6.	Acetaminophen (Paracetamol)FDA LinkGeneric 08/01/2005 - "Tolerance and analgesic efficacy of a new i.v. paracetamol solution in children after inguinal hernia repair." 10/01/2011 - "Post incisional wound infiltration with levobupivacain has significantly better efficacy to rectal administration of paracetamol with respect to providing pain relief following inguinal hernia repair in children. " 04/01/2010 - "In this prospective, randomized, double-blinded study we sought to evaluate the efficacy and safety of combined use of intravenous ketorolac and acetaminophen in small children undergoing outpatient inguinal hernia repair. " 12/01/2007 - "Pre-operative analgesia with rectal diclofenac and/or paracetamol in children undergoing inguinal hernia repair." 08/01/2005 - "A single infusion of i.v. paracetamol 15 mg.kg(-1) produced analgesia similar to a single infusion of propacetamol 30 mg.kg(-1) following inguinal hernia repair in children. "
7.	Fibrin Tissue Adhesive (Fibrin Sealant)IBA 01/01/2003 - "This study showed that human fibrin glue is effective in preventing local hemorrhagic complications after inguinal hernia repair in patients with concurrent coagulation disorders." 01/01/2001 - "To evaluate the efficacy of mesh fixation with fibrin sealant (FS) in laparoscopic preperitoneal inguinal hernia repair and to compare it with stapled fixation. " 03/01/1999 - "Our purpose was to establish the efficacy of human fibrin glue (HFG) in preventing coagulative complications after inguinal hernia repair in patients with coagulation disorders. " 10/01/2014 - "Post-operative benefits of Tisseel(®)/Tissucol (®) for mesh fixation in patients undergoing Lichtenstein inguinal hernia repair: secondary results from the TIMELI trial." 04/01/2012 - "Randomized, controlled, blinded trial of Tisseel/Tissucol for mesh fixation in patients undergoing Lichtenstein technique for primary inguinal hernia repair: results of the TIMELI trial."
8.	Lidocaine (Xylocaine)FDA LinkGeneric 11/01/1997 - "The study results indicate that 1.5% lidocaine is as effective as the 5% solution as a spinal anesthetic for patients undergoing inguinal hernia repair." 04/01/2013 - "Patients with inguinal hernia undergoing tension-free mesh repair under local infiltration anaesthesia were randomized to receive 0.25% (Group A), 0.33% (Group B) or 0.5% (Group C) lidocaine. " 04/01/2013 - "Low concentrations of lidocaine for inguinal hernia repair under local infiltration anaesthesia." 04/01/1993 - "Evaluation of the safety of inguinal hernia repair in the elderly using lignocaine infiltration anaesthesia." 04/01/2013 - "A randomized, double-blind, prospective, controlled study to determine the lowest concentration of lidocaine that provides satisfactory anaesthesia and analgesia for inguinal hernia repair. "
9.	levobupivacaine (Chirocaine)FDA Link 09/01/2015 - "In inguinal hernia repair, it is possible that local spraying of 0.25% levobupivacaine exerts the same effect as 0.5% levobupivacaine." 09/01/2015 - "[Comparison of Postoperative Analgesic Effects between 0.25% Levobupivacaine and 0.5% Levobupivacaine Local Instillation in Inguinal Hernia Repair]." 03/01/2011 - "Two hundred and seventy-three patients undergoing day-case open inguinal hernia repair with a mesh were randomly allocated to receive either ultrasound-guided TAP block or blind IHN block with levobupivacaine 0.5%, before surgery. " 09/01/2015 - "We compared retrospectively postoperative analgesia of two concentrations of levobupivacaine by local spraying in radical repair of inguinal hernia. " 09/01/2011 - "The successful application of awake caudal anesthesia with levobupivacaine for inguinal hernia repair in 15 low birth weight neonates is reported. "
10.	ropivacaine (Naropin)FDA LinkGeneric 08/01/2011 - "Seventy-five children, 1 month to 6 yr, undergoing inguinal hernia repair or more distal surgery were randomized to receive a caudal block with 0.7, 1.0, or 1.3 ml kg(-1) ropivacaine. " 12/01/1999 - "Pharmacokinetics and pharmacodynamics of ropivacaine 2 mg/mL, 5 mg/mL, or 7.5 mg/mL after ilioinguinal blockade for inguinal hernia repair in adults." 01/01/2015 - "The use of ultrasound-guided regional anesthesia with ropivacaine as an anesthetic in inguinal hernia repair for elderly patients is safe and effective, and ropivacaine is optimally effective at the concentration of 0.5% with least side effects." 10/01/2012 - "Local instillation of 0.75% ropivacaine is safe and effective, and provides adequate analgesia for a long period in adult patients following an inguinal hernia repair procedure." 07/01/2001 - "The aim of this study was to evaluate the pharmacokinetics, feasibility, and clinical effects of ropivacaine in regional anesthesia (ilioinguinal-iliohypogastric blocks [IIB], genitofemoral block plus local infiltration) for inguinal hernia repair. "

Therapies and Procedures

1.	Local Anesthesia 07/01/1984 - "In the postinfarction patient with an inguinal hernia, the dual goals of complete cardiac rehabilitation and improved quality of life can be facilitated in a safe and sure manner by elective inguinal herniorrhaphy under local anesthesia." 01/01/2008 - "Moreover, it offers the advantage of allowing the patient to undergo preperitoneal inguinal hernia repair under local anesthesia, which is especially beneficial for older patients with preoperative morbidity." 12/01/2014 - "Our results suggest that local anesthesia with the tumescent technique is an effective and safe modality for inguinal hernia repairs." 04/01/2009 - "The use of local anesthesia in inguinal hernia repair with tension-free hernioplasty is a safe and effective alternative for inpatient treatment." 01/01/1996 - "The Shouldice procedure associated to local anesthesia and antibio-prophylaxy remains the gold standard for the treatment of inguinal hernia."
2.	Analgesia 04/01/2006 - "We conclude that local cooling is a safe and effective technique for providing analgesia following inguinal hernia repair." 01/01/2013 - "The efficacy of the semi-blind approach of transversus abdominis plane block on postoperative analgesia in patients undergoing inguinal hernia repair: a prospective randomized double-blind study." 09/01/2011 - "This study has demonstrated that a single level single injection paravertebral block provides superior intraoperative and postoperative analgesia when compared to a caudal block for unilateral inguinal hernia repair." 10/01/2008 - "In this study, the use of medications for analgesia and/or sedation for incarcerated inguinal hernia reductions in the emergency department was analyzed. " 01/01/2015 - "Sub facial LA inguinal field block provides effective anaesthesia with optimum post op analgesia, prompt recovery and fewer systemic side effects compared to SA and can safely be used for routine open inguinal hernia surgery."
3.	Prostheses and Implants (Prosthesis) 10/01/1997 - "Good results have been obtained by using prosthesis in the treatment of inguinal hernia. " 07/01/2005 - "Using mesh or a synthetic prosthesis during tension-free inguinal hernia repair has been shown to be safe and effective. " 07/01/2002 - "Using mesh or a synthetic prosthesis during the laparoscopic repair of inguinal hernias has been demonstrated to be safe and effective. " 04/01/2005 - "The purpose of this study is to describe three oncology patients with persistent FDG up-take around inguinal mesh prostheses that occurred up to 10 years after the surgical repair of inguinal hernias and led to false-positive results. " 05/01/2015 - "This retrospective study examines the efficacy of our originally designed D-13 prosthesis, which is used in patients with inguinal hernias. "
4.	Spinal Anesthesia 10/01/2014 - "We hypothesized that spinal anesthesia is a feasible and safe option for inguinal hernia repair in infants even at high risk and cases of incarceration. " 05/01/2012 - "Spinal anesthesia is safe and effective for inguinal hernia repair in preterm infants, with early resumption of oral feeding and short hospitalization. " 10/01/2008 - "Laparoscopic total extraperitoneal inguinal hernia repair under spinal anesthesia: a study of 480 patients." 06/01/2005 - "This randomized, double-blind trial studied 40 men undergoing elective inguinal hernia repair under spinal anesthesia. " 05/01/2002 - "Fifty male patients scheduled for inguinal hernia repair with spinal anesthesia were included in this study. "
5.	Antibiotic Prophylaxis 08/01/2006 - "This study demonstrates the efficacy of antibiotic prophylaxis in inguinal hernia surgery in the subgroup of high-risk patients." 04/01/2002 - "In minor clean procedures, such as inguinal hernia repair and varicocelectomy, the efficacy of systemic perioperative antibiotic prophylaxis is not well established. " 04/01/2012 - "In this double-blind prospective randomized trial, our objective was to investigate the effect of antibiotic prophylaxis in patients undergoing elective inguinal hernia surgery with mesh repair in a large-volume tertiary referral trauma center. " 02/01/2012 - "Previous reviews of the effectiveness of antibiotic prophylaxis for elective inguinal hernia repair were not conclusive owing to the limited number of patients enrolled in randomized controlled trials (RCTs). " 02/01/2007 - "From the results of this study it does not appear that antibiotic prophylaxis offers any benefits in the elective mesh inguinal hernia repair."