Hérnia Inguinal: Anatomia, Patofisiologia, Diagnóstico e Tratamento

  • André Goulart Interno de Formação Específica de Cirurgia Geral Hospital de Braga
  • Sandra Martins Assistente de Anatomia da Escola de Ciências da Saúde da Universidade do Minho Investigadora do Instituto de Investigação em Ciências da Vida e da Saúde (ICVS) e ICVS/3B’s Laboratório Associado da Universidade do Minho

Abstract

A hérnia inguinal é uma das patologias mais frequentes que se coloca ao Cirurgião Geral. Muitas vezes considerada de menor importância, esta acarreta um impacto importante quer pela interferência na qualidade de vida diária do doente quer em termos sociais pelo absentismo laboral. A evolução do conhecimento anatómico e da técnica cirúrgica permitiu ao cirurgião dispor de diversas técnicas, colocando hoje em dia o problema na seleção da melhor técnica cirúrgica para cada doente. Neste artigo, os autores descrevem a anatomia da região inguinal do ponto de vista da abordagem cirúrgica, os fatores predisponentes e desencadeantes do aparecimento da hérnia inguinal, o diagnóstico desta patologia e a evolução da cirurgia; abordando alguns temas de controvérsia atual no tratamento desta patologia.

Downloads

Download data is not yet available.

References

1. Tatay FC. Hernia inguinocrural. 1 ed. Valencia: Ethicon; 2001.

2. Skandalakis PN, Skandalakis JE, Colborn GL, Kingsnorth AN, Weidman TA, Skandalakis LJ. Abdominal Wall and Hernias. In: Skandalakis JE, ed. Skandalakis’ Surgical Anatomy – The Embryologic and Anatomic Basis of Modern Surgery: Paschalidis Medical Publications; 2004:393-491.

3. LeBlanc KA. Laparoscopic hernia surgery: an operative guide. London: Arnold; 2003.

4. Matthews RD, Neumayer L. Inguinal hernia in the 21st century: an evidence-based review. Curr Probl Surg 2008;45:261-312.

5. Bendavid R. The unified theory of hernia formation. Hernia 2004;8:171-6.

6. Simons MP, Aufenacker T, Bay-Nielsen M, et al. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 2009;13:343-403.

7. Nyhus LM. Individualization of hernia repair: a new era. Surgery 1993;114:1-2.

8. Campanelli G, Pettinari D, Nicolosi FM, Cavalli M, Avesani EC. Inguinal hernia recurrence: classification and approach. Hernia 2006;10:159-61.

9. Miserez M, Alexandre JH, Campanelli G, et al. The European hernia society groin hernia classification: simple and easy to remember. Hernia 2007;11:113-6.

10. Townsend CM, Beauchmap RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery. 18 ed. Philadelphia: Saunders Elsevier; 2008.

11. Leander P, Ekberg O, Sjoberg S, Kesek P. MR imaging following herniography in patients with unclear groin pain. Eur Radiol 2000;10: 1691-6.

12. Fon LJ, Spence RA. Sportsman’s hernia. Br J Surg 2000;87:545-52.

13. McClusky III DA, Mirilas P, Zoras O, Skandalakis PN, Skandalakis JE. Groin Hernia: Anatomical and Surgical History. Arch Surg 2006;141:1035-42.

14. Zollinger J, Robert M, Zollinger S. Zollinger’s Atlas of Surgical Operations: McGraw-Hill Professional; 2002.

15. Campanellia G, Canziania M, Frattinia F, Cavallia M, Agrusti S. Inguinal hernia: State of the art. Int J Surg 2008;6:S26–S8.

16. Rosenberg J. Pediatric inguinal hernia repair-a critical appraisal. Hernia 2008;12:113-5.

17. Mollen KP, Kane TD. Inguinal hernia: what we have learned from laparoscopic evaluation of the contralateral side. Curr Opin Pediatr 2007;19:344-8.

18. Lau ST, Lee YH, Caty MG. Current management of hernias and hydroceles. Semin Pediatr Surg 2007;16:50-7.

19. Parelkar SV, Oak S, Gupta R, et al. Laparoscopic inguinal hernia repair in the pediatric age group--experience with 437 children. J Pediatr Surg 2010;45:789-92.

20. Amato B, Moja L, Panico S, et al. Shouldice technique versus other open techniques for inguinal hernia repair. Cochrane Database Syst Rev 2009:CD001543.

21. Feliu X, Claveria R, Besora P, et al. Bilateral inguinal hernia repair: laparoscopic or open approach? Hernia 2010.

22. Griffin KJ, Harris S, Tang TY, Skelton N, Reed JB, Harris AM. Incidence of contralateral occult inguinal hernia found at the time of laparoscopic trans-abdominal pre-peritoneal (TAPP) repair. Hernia 2010;14:345-9.

23. National Institute for Health and Clinical Excellence (NICE). Laparoscopic Surgery for Inguinal Hernia Repair. In: NICE. London 2004.

24. Karthikesalingam A, Markar SR, Holt PJ, Praseedom RK. Meta-analysis of randomized controlled trials comparing laparoscopic with open mesh repair of recurrent inguinal hernia. Br J Surg 2010;97:4-11.

25. Derici H, Unalp HR, Nazli O, et al. Prosthetic repair of incarcerated inguinal hernias: is it a reliable method? Langenbecks Arch Surg 2010;395:575-9.

26. Elsebae MM, Nasr M, Said M. Tension-free repair versus Bassini technique for strangulated inguinal hernia: A controlled randomized study. Int J Surg 2008;6:302-5.

27. Franklin ME, Jr., Trevino JM, Portillo G, Vela I, Glass JL, Gonzalez JJ. The use of porcine small intestinal submucosa as a prosthetic material for laparoscopic hernia repair in infected and potentially contaminated fields: long-term follow-up. Surg Endosc 2008;22:1941-6.
Published
2015-06-29
How to Cite
GOULART, André; MARTINS, Sandra. Hérnia Inguinal: Anatomia, Patofisiologia, Diagnóstico e Tratamento. Revista Portuguesa de Cirurgia, [S.l.], n. 33, p. 25-42, june 2015. ISSN 2183-1165. Available at: <https://revista.spcir.com/index.php/spcir/article/view/510>. Date accessed: 28 mar. 2024.
Section
Review Article