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Perioperative management - Rutkow plug repair in inguinal hernia

general and visceral surgery
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Anatomy Perioperative management Technique Complications Evidence Total Video

  1. Indications

    • Indirect hernia (Schumpelick L I-III)
    • Direct hernia (Schumpelick M I-III)
    • Femoral hernia (Schumpelick F I-III)
    • Recurrent hernia (Schumpelick R I-III)
    • Combined hernia (Schumpelick ML I-III)

  2. Contraindications

    • The same restrictions/recommendations for patients < 30 years as in the other surgical procedures with alloplastic meshes.
    • Patients in endstage of a malignancy
    • High-risk surgical patients

  3. Preoperative diagnostic work-up

    • Clinical examination
    • Ultrasonography with 7.5 MHz probe with patient standing and supine to rule out hydrocele, malignancy (e.g., sarcoma), lipoma

  4. Special preparation

    • Marking the side of the hernia examined with the patient standing
    • Reduce the potential of infection by shaving the surgical field just before the procedure is started
    • 1/2 hour before skin incision a single-shot antibiotic regimen is recommended, e.g., with 2nd generation cephalosporin
Informed consent

SeromaMesh migrationChronic inflammation reactionLate-onset infectionMesh shrinkage by scar contrac

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