Preface

Chapter 7 **Worst Case Scenarios! Complications Related to**

Nugud and Shomous Abd Elwahab Nugud

Ahmed Alwahab, Abdulrahman AlAwadhi, Asmaa Abd Alwahab

**Hernial Disease 93**

**VI** Contents

Hernia is one of the most ancient surgical problems affecting the mankind. Since the earliest time, various operative and nonoperative modes of treatment for the correction of hernias were introduced and practiced by surgeons. There were various strange surgical operative approaches in practice ranging from excision of the testicles to various noninterventional methods like bleeding the patients and keeping them sedated so as to reduce the obstructed hernias. A number of eminent surgeons of their time tried different strategies for the careful management of hernia. The hernia surgery has passed through a long phase of evolution from the very basic repair by Dr. Edoardo Bassini (1844–1924), who was an Italian surgeon. He presented his technique based purely on the anatomy of the inguinal region and suggest‐ ed a repair procedure by using a suture repair to strengthen the posterior wall of inguinal canal. Dr. Edward Earle Shouldice (1890–1965) introduced the concept of reinforcing the in‐ guinal canal by applying the mesh to repair inguinal hernias. There were many complica‐ tions associated with these traditional procedures for the repair of inguinal and other hernias of which the most dreaded and common complication was the recurrence of the her‐ nia. The surgeons were in a continuous struggle to find an optimal procedure that will offer the best possible surgical procedure to the hernia patients. In 1987, Dr. Irving Lichtenstein reported the consequences of 6321 patients showing a substantially low rate of recurrence after surgery with Marlex (polypropylene) prosthetic material. His strategy bearing his name was termed "tensionless" repair, and after some time, this has turned into a mainstay of hernia repair. The tensionless repair continued and even today is practiced all over the world. The introduction of laparoscopic repair of hernia repair has changed the outlook of hernia patients globally. The current laparoscopic technique involves applying the mesh ei‐ ther through a totally extra-peritoneal approach or through a trans-peritoneal approach.

This book gives a very deep insight into the rapidly changing field of hernia surgery. The eminent surgeons involved in the field have contributed their respective experiences regard‐ ing the most recent patterns and specialized adjustments for both normal and complex her‐ nias. The readers will certainly gain a lot of knowledge regarding the basic anatomical concepts and the various advancements in the different techniques offered for the correction of different hernias. Positive critical observations and suggestions will be highly appreciated.

> **Dr. Arshad M. Malik** Associate Professor of Surgery College of Medicine Qassim University Kingdom of Saudi Arabia

**Section 1**

**A Brief Note on Hernia Surgery**

**A Brief Note on Hernia Surgery**

**Chapter 1**

**Provisional chapter**

**Introductory Chapter: Hernia Surgery and the**

**Introductory Chapter: Hernia Surgery and the** 

DOI: 10.5772/intechopen.77977

Hernias are as old as history of mankind. The history of hernia dates back to 400 BC when Ancient Greeks diagnosed and proposed various modes of treatment. The word hernia has its origin from the Greek word hernios, a bud or a shoot. Despite the fact that the common course of the hernia was not sudden and the progress was typically slow, it eventually grows to an enormous size at times and could make the life of the patient difficult as far as the routine work was concerned. This coupled with an impending danger of complications made it

For many years, different surgical and nonsurgical options were practiced and offered to patients experiencing complicated hernias such as obstructed and strangulated hernias. One of the common strategy included surgery with castration as a component to get rid of the complicated hernia. Nonsurgical strategies comprised principally of applying pressure belts to keep the hernia contents from descending into scrotum. This was done after reducing the contents of the hernia sac and then applying firm pressure of the belt especially on to the deep inguinal ring to keep the passage of hernia completely blocked. The other methods included phlebotomy, tobacco douches, and exceptional eating methodologies. Curiously, trusses (pressure gadget) were additionally portrayed and utilized for noncomplicated hernias and

Hernia surgery has made a tremendous improvement in the surgical treatment over many decades from basic repair to the present laparoscopic repair. Various pioneer specialists presented different techniques for the surgical correction and repair of hernia. Among all, the

> © 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

**Developing World**

**Developing World**

Additional information is available at the end of the chapter

mandatory for the physicians to find out some remedy.

that option continues even today.

**1.1. Evolution of hernia surgery**

Arshad M. MalikAdditional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.77977

Arshad M. Malik

**1. Introduction**

#### **Introductory Chapter: Hernia Surgery and the Developing World Introductory Chapter: Hernia Surgery and the Developing World**

DOI: 10.5772/intechopen.77977

Arshad M. Malik

Additional information is available at the end of the chapter Arshad M. MalikAdditional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.77977
