This talk was presented at the 2018 SAGES Meeting/16th World Congress of Endoscopic Surgery by David C Chen during the Masters Hernia: Recurrent Hernias – Making the Best of a Bad Situation on April 11 2018
Keyword(s): 3D mesh, abdominal wall atrophy, algorithm, anatomy, anterior approach, argon beam, atrophy, balloon, Bassini repair, bleeding, chronic pain, conjoint tendon, decision making, dermatomal mapping, diagnosis, dissection, epigastric vessels, eTEP, European Hernia Society guidelines, explanted mesh, female, femoral cutaneous injury, foreign body, general surgery, genitofemoral nerve, groin hernia, H&P, Hernia Surge, history & physical, hybrid approach, iliohypogastric nerve, ilioinguinal nerve, imaging studies, inflammation, informed consent, inguinal canal, inguinodynia, insurance, internal ring, international guidelines, laparoscopic inguinal hernia repair, Lichtenstein repair, LIHR, male, masters hernia, mesh, mesh removal, meshectomy, meshoma, minimally invasive surgeon, MIS surgeon, nerve injury, neurectomy, neuropathic pain, nociceptive pain, numbness, op report, open inguinal hernia repair, operative report, outcomes, paraesthesia, pediatric hernia, pediatric surgeons, peritoneum, Phillips repair, PHS mesh, plug & patch, posterior repair, psoas, recommendations, recurrent hernia, registry, reoperation, retroperitoneal neurectomy, robotic hernia repair, robotic inguinal hernia repair, scarring, self-gripping mesh, Shouldice clinic, Shouldice repair, specimen, spermatic cord, spermatic vessels, tacks, TAPP, TEP, testicular atrophy, testicular loss, tissue repair, triple neurectomy, ultrasound, vas deferens, vascular injury
Groin hernias–21 sec
Recurrence–1:01
Tx algorithm 1:54
Pain algorithm–2:07 Hernia 2015
Recurrence & pain tx algorithm–2:48
How do we treat chronic pain in the setting of recurrence?–3:34
Types of pain–5:23
Nociceptive pain–5:39
Neuropathic pain–6:55
Neuroanatomy of chronic pain–7:03
Citation–7:40 Hernia 2016
Types of IHR–9:15
Decision making: Mapping–9:21
Operative tailoring–10:10
Recurrence with hernia related pain–11:05
Recurrence after open repair–11:42
Recurrence + pain after lap repair–12:33
Lap recurrence & neuropathic pain–13:56
Hybrid approach–14:35
Dangers & pitfalls–15:32
Tips & tricks–16:06
Conclusion–16:24