Talk:Inguinal hernia surgery

Untitled

I added a mention of non-surgical possible alternative "treatment" (pilates exercises), although to my knowledge, these exercices are not backed by peer-reviewed medical evidence. Wikipedia:MEDRS#Other_sources says that non-academic sources should be used with caution (though it does not say that they should not be used at all), so this deserves explanation:

This non-surgical alternative "treatment" dates back to the pre-surgery era of the 19th century (historical references are welcome), and the idea that exercices can replace surgery is notable and still widely held (see forums, etc...I can give references on request). The purpose of mentioning them on wikipedia is twofold:

1. to my knowledge, these exercices are not supported by any medical study (whatever your friend/doctor/surgeon will say).

2. to my knowledge, these exercices are not denied by any medical study either (whatever your friend/doctor/surgeon/medical website will say), though, given their popularity and a priori reasonableness (hernia is due to muscular weakness), they certainly deserve to be assessed clinically.

So the good compromise seems to mention them, while insisting that they are not backed by medical studies, and warn the reader that they must be taken with caution.

We are to reflect high quality literature rather than add or own personal knowledge.Doc James (talk · contribs · email) 11:41, 23 January 2012 (UTC)

I agree that high quality literature must be cited whenever possible. But see also http://en.wikipedia.org/wiki/Wikipedia:Identifying_reliable_sources_(medicine)#Other_sources which says "they are usually poor sources and should always ***be used with caution***, never used to ***support*** surprising claims, and ***carefully identified*** in the text as preliminary work. **as much as possible** Wikipedia articles should cite the more established literature directly." I am not adding personal knowledge, I am just following these guidelines. See WP:MEDASSESS and see also WP:COMPREHENSIVE. If you have a high-quality evidence about this notable century-old method, feel free to share it, it will be more constructive than doing reverts. — Preceding unsigned comment added by Mokotillon (talk • contribs) 14:51, 23 January 2012 (UTC)

Mokotillon (talk) 14:54, 23 January 2012 (UTC)

If you wish further input on your edits feel free to ask for it at WT:MED. The refs in question are however not sufficient.Doc James (talk · contribs · email) 16:07, 23 January 2012 (UTC)

Wiki Education Foundation-supported course assignment

This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): Averstumor. Peer reviewers: DrKMD.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 23:00, 17 January 2022 (UTC)

External link be changed in References and addition be made in Tension free pure tissue repairs-Desarda

1] External link provided at 52 of the references be changed to www.desarda.com/articles. This will take readers directly to the articles to read.www.desarda.com/articles Existing external link requires readers to go through 3 links to open the article to read. 2] Addition be made in the "Tension free pure tissue repairs-Desarda" section that this pure tissue repair technique is added in the hernia chapter of the "Baily & Love-Text book of surgery as a part of the corriculum to the medical students and the graduates to study and learn. Baily & Love-Text book of surgery, 26th edition published in Feb 2013. Desarda (talk) 17:27, 30 July 2014 (UTC)

I asked for help at Wikipedia_talk:WikiProject_Medicine#Edit_request_needs_some_knowledgeable_help --S Philbrick(Talk) 13:50, 2 August 2014 (UTC)

I have deleted the reference. An index of sources is not a suitable reference. The statement already has three other references, although they are primary sources. I shall try to get hold of a copy of Bailey & Love. Axl ¤ [Talk] 16:32, 2 August 2014 (UTC)

Bailey & Love, 26th edition, has one paragraph about the procedure (page 957): "Suture repair is still under development, and recently, Desarda has described an operation where a 1–2-cm strip of external oblique aponeurosis lying over the inguinal canal is isolated from the main muscle but left attached both medially and laterally. It is then sutured to the conjoint tendon and inguinal ligament, reinforcing the posterior wall of the inguinal canal. As the abdominal muscles contract, this strip of aponeurosis tightens to add further physiological support to the posterior wall. This operation is currently being evaluated."

This whole article is filled with inappropriate primary sources. It needs to be re-written from the ground up. Axl ¤ [Talk] 17:23, 2 August 2014 (UTC)

agreed. i just declined the request so it goes off the requested edit list. Jytdog (talk) 01:20, 12 October 2014 (UTC)

Erectile Dysfunction and inguinal hernias, an underestimated relationship

as the title says I believe, no, I know by my own recent experience that these two things correlate strongly together in some patients, at least in me, because I'm cured of severe ED by chance via a simple TAPP intervention done at our local hospital. I took Sildenafil 75 mg before which was really expensive because I'm still young with my 33 years of age and now I must see that because no one knew about this brilliant publication or misjudged it because it used not a standard questionnaire but a modified, but also validated, one, I had no (fullfilling, complete, at all) sex in my whole life until now. This is puzzling at best. I'm totally lost how nobody had ever followed this promising track academically/scientifically in the whole world despite the clear data given here. Can anyone tell me why?!? — Preceding unsigned comment added by Malv0isin (talk • contribs) 12:02, 12 August 2015 (UTC)

Shouldice method claims to NOT use tension

Hello, I am not an experience wikipedia user. I am researching Inguinal hernia surgery and contrary to this article, the Shouldice Hospital states that their method does not use tension:

From this URL: <ref> http://www.shouldice.com/the-shouldice-hernia-repair-surgery.html <ref> under the tab "The operation" they state:

"The muscles and connective tissue of the abdominal wall are arranged in three separate layers. Before repairing any weakness, we gently place the fatty tissue and any part of the intestine (bowel) that may have bulged through the abdominal wall back inside the abdomen. Then we repair each muscle layer individually, using a technique that puts no tension on the natural tissue. By carefully overlapping and securing each layer, just like you do when you button a coat, we strengthen and reinforce this section of the abdominal wall."

Therefore, shouldn't the Shouldice method be place instead into the non-tension surgery section further down?

Thanks. ˜˜˜˜ — Preceding unsigned comment added by Bigmaple (talk • contribs) 20:37, 6 July 2016 (UTC)

Muschaweck-Berger: a new technique or the same as Desarda/Guarnieri?

I came across https://web.archive.org/web/20130330092920/http://www.rapidrecovery.net/hernia.html a few years ago (mentioned starting from page 3): is it a new technique?
The referenced paper is: Ulrike Muschaweck, Luise Berger Minimal Repair technique of sportsmen’s groin: an innovative open-suture repair to treat chronic inguinal pain The RedBurn (ϕ) 09:57, 27 August 2017 (UTC)

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Page Reorganization and Update

1. Which sections will I prioritize?

• Introduction
• Indications for surgical repair
• Contraindications for surgical repair
• Surgical options
• Non-surgical management
• Complications and prognosis
• Follow-up
• Prevention and screening

2. What resources do I intend to look up, and when?

1. • https://www.niddk.nih.gov/health-information/digestive-diseases/inguinal-hernia
2. • https://medlineplus.gov/hernia.html
3. • P. Wagner J, Brunicardi F, Amid PK, Chen DC. Inguinal Hernias. In: Brunicardi F, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, Pollock RE. eds.'Schwartz's Principles of Surgery, 10e New York, NY: McGraw-Hill; 2015. http://accesssurgery.mhmedical.com/content.aspx?bookid=980&sectionid=59610879. Accessed November 20, 2017.
4. • https://www.uptodate.com/contents/overview-of-treatment-for-inguinal-and-femoral-hernia-in-adults?source=search_result&search=inguinal hernia repair&selectedTitle=1~33
5. • http://www.dynamed.com/topics/dmp~AN~T113880/Groin-hernia-in-adults-and-adolescents#anc-1677115275
6. • https://www.sages.org/publications/patient-information/patient-information-for-laparoscopic-inguinal-hernia-repair-from-sages/
7. • https://jamanetwork.com/journals/jama/fullarticle/2633918
8. • D. Brock Hewitt, Karen Chojnacki. Laparoscopic Groin Hernia Repair. JAMA. 2017;318(13):1294. doi:10.1001/jama.2017.11620
9. • D. Brock Hewitt, Karen Chojnacki. Groin Hernia Repair by Open Surgery. JAMA. 2017;318(8):764. doi:10.1001/jama.2017.9868
10. • https://www.mayoclinic.org/diseases-conditions/inguinal-hernia/diagnosis-treatment/drc-20351553
11. • All within the next 7 days ending 11/27/17

3. How will I decide what things (signs, symptoms, side-effects, etc.) to explicitly include? To explicitly exclude?

• • I will refer to the above sections that I will be prioritizing as a guide of information to include or exclude. An example being symptoms that warrant surgical consideration include (x, y, z). I will exclude information pertaining to the definition, diagnosis, differential and confirmatory testing of inguinal hernias as that has been well covered in a separate article.

4. Will I also embed additional links to other Wiki pages?

• • Yes, the wiki page on inguinal hernias and other pages as deemed helpful to the lay-reader.

5. How will I ensure I avoid "doctor-speak" and not use jargon?

• • Have my mom read the page and provide appropriate feedback.

Averstumor (talk) 20:26, 20 November 2017 (UTC)

== Peer Review ==

I have taken some time to read through this article and review it as part of a WikiEd course. I was impressed by the content and structure of this article and it has clearly been improved by the recent editing! The article's lead section definitely conveys the importance of the topic, especially by providing epidemiological data in the last paragraph. The order of article sections is organized in a way that makes sense and flows well while reading. The article might eventually benefit from the inclusion of a 'History' section which covers the invention and evolution of the surgery, although it is less relevant than the other current content and is not a priority to the topic.

The article is well-balanced, with the proper section headings per Wikipedia:MEDMOS and evenly weighted content. I particularly like that the 'Indications for surgery' section is concise. It is a good overview of indications without sounding like it is attempting to provide specific medical advice. While there are clearly many different techniques to discuss for inguinal hernia surgery, the more prominent approaches are given more weight and those that are outdated or less commonly used receive less attention in the article. This appears balanced with the relevance of each subsection to the overall topic and the opinions of current literature. It does not seem as though the author is making any attempt to persuade the reader of the superiority of any one technique over the other; the voice is neutral, and the information presented on risks and benefits of each approach is supported by relevant citations. The article appears to contain an appropriate number and distribution of citations, and the materials cited seem to be reliable and current sources. The only exception I noted is Reference #2, which is cited as an article from 'www.uptodate.com' but has missing information and thus cannot be easily accessed. I would recommend revising this citation or removing it!

Overall, the article is understandable and the content is relevant to the article's topic. I think that the section on 'Surgical approaches' does a fantastic job of describing the benefits of the different techniques while maintaining neutrality and giving each approach equal weight. I particularly appreciated the wording used to describe the use of prosthetic mesh during open repair and the different types of anesthesia. These are potentially confusing topics that are presented in very understandable language. The description of the different types of mesh products available uses a great deal of jargon, but the difficult terminology is appropriately linked for further investigation by readers. Additionally, the 'Complications and prognosis' section does a great job of using plain language to describe potential risks.

The article still has a few areas that could easily be improved to make them more clear and understandable for laypersons. For example, some of the terminology presented in the 'Indications for surgery' section would be difficult for a layperson to understand, e.g. "the small intestine has become incarcerated or strangulated". These terms are defined in the 'Lead' section of the article but it might make more sense to non-medical readers if they were also described when presented lower in the article. There are some small typographical errors in the 'Open hernia repair' subsection which I found minorly distracting. In addition, in the 'Contraindications to surgery' section at the first bullet point which states that "Patients with unstable medical conditions" have high risks with surgery, it might be beneficial to include a parenthetical list of some of the more common unstable medical conditions which would be valid contraindications to inguinal hernia surgery, possibly with links to other wikipedia articles. I do not mean for it to become a long tangent within the overall structure of the section, as I recognize that it is meant to be concise, but as a reader I would not know how to find out more about what that bullet point meant without some guidance.

These are merely suggestions, and are meant to reflect my opinions on how to improve the article further. I do not mean for them to minimize the value of the extensive work already dedicated to making the article as it exists now! Great job overall. It looks like you have done well with sticking to your above Work Plan and I like what you have added!!

--DrKMD (talk) 01:21, 11 December 2017 (UTC)

Hi @DrKMD:, thank you so much for taking the time to review this article. Your comments are not only uplifting but also suggest changes that I think will ultimately benefit all readers of the article. I organized the article in a manner that flowed more like a patient informational brochure. I agree that the addition of a “history” section would be a helpful addition to the article. I sought to rely heavily on systematic reviews, society guidelines and other well-cited review sources to build the information within the article. You made note of a difficult to access citation that I will work towards improving. Some terms that I had introduced in the Lead as well as common unstable conditions would indeed benefit from being re-defined as I’m sure many readers may skip around the article. I’m glad you pointed out the typographical errors as I had completely missed them. Again, thank you very much for your encouraging words, insight, and helping to make the article a helpful resource for many to come. Averstumor (talk) 14:25, 14 December 2017 (UTC)

"Introduction" section

Hi @Averstumor:, thanks for your help to improve this article. I have moved your edit to this Talk Page for now, as it removed the present "Lead" in the article. Please review WP:MEDMOS for important information on headings. There is also information on Leads specifically here: WP:LEAD: "As a general rule of thumb, a lead section should contain no more than four well-composed paragraphs and be carefully sourced as appropriate."

Please also read these documents for how to effectively use references in a lead. IMO, rather than re-write the entire lead, I would suggest start by making small improvements, learn from them (wiki-style), and then expand from there.

Thanks again for making the effort to improve this article. We greatly appreciate people with medical backgrounds helping to improve Wikipedia. If you have any questions, please let me know. JenOttawa (talk) 02:45, 5 December 2017 (UTC)

Introduction

Open surgical repair of a right inguinal hernia Inguinal hernia surgery is an operation to repair a weakness in the abdominal wall that abnormally allows abdominal contents to slip into a narrow tube called the inguinal canal in the groin region. Surgery remains the ultimate treatment for all types of hernias as they will not get better on their own, however not all require immediate repair.[1][2] Patients who experience little to no symptoms are often advised to remain vigilant as the benefit of surgery may be outweighed by the risks of undergoing an operation. Elective surgery is offered to most patients taking into account their level of pain, discomfort, degree of disruption in normal activity, as well as their overall level of health.[1] Emergency surgery is typically reserved for patients with life-threatening complications of inguinal hernias such as incarceration and strangulation. Incarceration occurs when intra-abdominal fat or small intestine becomes stuck within the canal and cannot slide back into the abdominal cavity either on its own or with manual maneuvers. Left untreated, incarceration may progress to bowel strangulation as a result of restricted blood supply to the trapped segment of small intestine causing that portion to die.[3] Successful outcomes of repair are usually measured via rates of hernia recurrence, pain and subsequent quality of life.[4] Surgical repair of inguinal hernias is one of the most commonly performed operations worldwide and the most commonly performed surgery within the United States. A combined 20 million cases of both inguinal and femoral hernia repair are performed every year around the world with 800,000 cases in the US as of 2003. Groin hernias account for almost 75% of all abdominal wall hernias with the lifetime risk of an inguinal hernia in men and women being 27% and 3% respectively. Men account for nearly 90% of all repairs performed and have a bimodal incidence of inguinal hernias peaking at 1 year of age and again in those over the age of 40. Although women account for roughly 70% of femoral hernia repairs, indirect inguinal hernias are still the most common subtype of groin hernia in both males and females.[5]

Hi @JenOttawa:, thanks for your constructive feedback. If I understand your concerns correctly they are as follows: 1) The lead had been removed and replaced. It was my attempt to follow the Lead guidelines via a) being simply written b)introducing content that will follow similar organization as the rest of the article and c) being less than 4 paragraphs. Perhaps you could clarify what changes need to be implemented? 2) The heading "intro" should not be present. I can remove this and have the article begin with my first line 3) The hyperlink to "inguinal hernia" in the first line should be modified/removed. I can remove the link, although it seems like a link is appropriate. Either via disambiguation or redirection according to WP:TMGDI Averstumor (talk) 19:11, 5 December 2017 (UTC)

Thanks Averstumor for taking the time to look through the content. In my opinion, you should use more citations. The lead is not quite like the body of the article (where we require a citation for every sentence, ideally), however, each time you present a point or evidence, a single high-quality citation should be used (this is my understanding). If you have read through the whole WP:LEAD and made sure you have not missed anything in the WP:MEDMOS that is specific to medical articles, I would say you could try your edit. Note: Please be sure that your lead is written in common terms (lay language) that can be understood by someone who is not in the field. Good luck and thanks again for your efforts to contribute to Wikipedia. JenOttawa (talk) 02:16, 6 December 2017 (UTC)

Dec 15 comment

Hi @Averstumor: Good work continuing to improve the article. I have started to change all the incidences of the use of "patients" to "people". In Wikipedia we do not refer to people as patients. Would you mind finishing off the article? Unfortunately, I am out of time tonight. I also found a large list of randomized controlled trials or other primary content from clinical trials cited in the paper. I removed them and the associated sentences. If you wish to add this information back in, please find a review. Looks like it was interesting information, so I think it would be worth it. Thanks again, we appreciate your efforts to improve the article. JenOttawa (talk) 02:34, 16 December 2017 (UTC)

Wiki Education assignment: UCSF SOM Inquiry In Action-- Wikipedia Editing 2022

This article was the subject of a Wiki Education Foundation-supported course assignment, between 8 August 2022 and 20 September 2022. Further details are available on the course page. Student editor(s): Edupp1993, Safa1364 (article contribs). Peer reviewers: Brownsugar415, Cheetahbonnet, Dblmnsn.

— Assignment last updated by Dblmnsn (talk) 17:59, 12 September 2022 (UTC)

CIC Peer Review 9/15/2022

I am reviewing the introduction section and the "Robotic Surgery" section, as indicated by my peers. Everything in these sections were relevant to inguinal hernia surgery and there was no information that was distracting from the article topic. The content of these sections are neutral, and does not appear to have any bias toward a particular position or favoring one type of surgery over another. Each fact presented is supported by an appropriate secondary source from peer-reviewed articles and reputable medical institutions. I checked the links of the sources in these sections and they all work appropriately. One note for feedback would be to use less medical jargon and more language that can be accessed by the general population. Brownsugar415 (talk) 21:03, 15 September 2022 (UTC)

I read the sections edited and added to by my peers, and the only feedback I have is that the introductory paragraph take time to get to what a hernia is and if I didn't know, I still would not be sure what it is. That could potentially be addressed in the first few sentences with more clarity.Dblmnsn (talk) 21:19, 15 September 2022 (UTC)

Adding information/graphic from NHS Decision Aid

Hi. I have recently finished working on the NHS Decision Aid for inguinal hernia treatments and am going to add some of the graphical information we made for that (and accompanying references) in the hope that it's helpful for readers. I'm relatively new to wikipedia editing so apologies in advance for any mistakes I make. I've been asked on another page I was editing to use the primary reference sources as references, so I shall do that but if someone prefers just to reference the decision aid as a summary source then it would be easy to remove them. Draljf (talk) 20:12, 17 September 2024 (UTC)