Recurrent Inguinal Hernia Pathological Types

Dr Sanjoy SanyalMBBS, MS (Surgery), MSc (UK), ADPHA, ADHRD

sanjoy.sanyal@bath.edu

Master of Surgery thesis in JIPMER, Pondicherry, India under guidance of Dr R. B. Mehta

Recurrent Inguinal Hernia• Recurrent Hernia: A surgical challenge• Following slides show Pathology and

Pathophysiology of Recurrences• Especially following previous Bassini-type of

Inguinal Hernia repair• Recurrences are classified as Medial /

Lateral depending on their relation to Inferior Epigastric Artery

• Last few slides show repair techniques without using prosthetic material

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Post-Repair of Recurrent Hernia

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Previous Bassini-Type Repair

Previous Bassini Repair – Medial Recurrence

Medial defect with a dome-shaped direct sac (arrow). Previous Bassini-type repair seen laterally

Previous Bassini Repair – Indirect Recurrence

Small Indirect Recurrence

Indirect Recurrence – Dilated IR

Small Indirect Sac in Mixed defect

Medial (Direct) Recurrence

Multiple Direct Recurrences

One of Many Direct Recurrences

Indirect (Lateral) Recurrence

Large Indirect Recurrence

Large Indirect Recurrence

Medial (Direct) Recurrence

Medial (Direct) Recurrence

Left Medial (Direct) Recurrence

Repair of Medial Recurrence

Repair of Medial Recurrence

Repair of Medial Recurrence

Medial Recurrent Defect

Medial Recurrent Defect

Lateral Recurrent Defect