Skip to main content
Log in

Diagnosis and classification of inguinal hernias

  • Original article
  • Published:
Surgical Endoscopy And Other Interventional Techniques Aims and scope Submit manuscript

Abstract

Background: The aim of this prospective clinical study was to determine whether the presence of a hernia, its size, and its type can be established preoperatively by clinical and ultrasound, examination. Methods: The study population comprised 220 consecutive patients referred to our department for the surgical management of an inguinal hernia. On admission, both inguinal regions were examined clinically and by ultrasound. All patients were operated on laparoscopically. Results: In regard to the intraoperative findings for both inguinal regions, clinical and ultrasound examination for the diagnosis of inguinal hernia yielded a high total rate of accuracy of 93% respective 94%. However, when the same methods were used to differentiate between lateral and medial hernia, the total rate of accuracy fell to only 54% respective 62%. In the determination of inguinal hernia size, it was even lower: 50% respective 53%. Conclusions: Although a diagnosis of inguinal hernia can be established reliably by clinical and ultrasound examination, only an approximate classification is possible by these methods.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. PK Amid AG Shulman IL Lichtenstein (1996) ArticleTitleOpen “tension free” repair of inguinal hernias: the Lichtenstein technique. Eur J Surg 162 447–453 Occurrence Handle1:STN:280:BymH3Mvhs1U%3D Occurrence Handle8817221

    CAS  PubMed  Google Scholar 

  2. IV Babkova VV Bozhko (1999) ArticleTitleUltrasound assessment in diagnosis of uncomplicated inguinal hernia. Khirurgiia (Mosk) 2 46–50

    Google Scholar 

  3. A Bau M Atri (2000) ArticleTitleAcute female pelvic pain: ultrasound evaluation. Semin Ultrasound CT MR 21 78–93 Occurrence Handle1:STN:280:DC%2BD3c7ltVOktQ%3D%3D Occurrence Handle10688069

    CAS  PubMed  Google Scholar 

  4. R Bittner (1995) Standardtechnik. R Bittner (Eds) Laparoskopische Hernioplastik Hippokrates Verlag Stuttgart 81–97

    Google Scholar 

  5. R Bittner K Kraft C-G Schmedt J Schwarz B Leibl (1998) ArticleTitleRisiko und Nutzen der laparoskopischen Hernioplastik (TAPP): 5 Jahre Erfahrung bei 3000 Hernienoperationen [in German]. Chirurg 69 854–858 Occurrence Handle10.1007/s001040050500 Occurrence Handle1:STN:280:DyaK1cvlsFOhsA%3D%3D Occurrence Handle9782402

    Article  CAS  PubMed  Google Scholar 

  6. KC Chen CC Chu TY Chou CJ Wu (1998) ArticleTitleUltrasonography for inguinal hernias in boys. J Pediatr Surg 33 1784–1787 Occurrence Handle1:STN:280:DyaK1M%2FosVeqtw%3D%3D Occurrence Handle9869050

    CAS  PubMed  Google Scholar 

  7. TY Chou CC Chu GY Diau CJ Wu MK Gueng (1996) ArticleTitleInguinal hernia in children: US versus exploratory surgery and intraoperative contralateral laparoscopy. Radiology 201 385–388 Occurrence Handle1:STN:280:ByiD2czgtlQ%3D Occurrence Handle8888228

    CAS  PubMed  Google Scholar 

  8. EA Deitch MC Soncrant (1981) ArticleTitleUltrasonic diagnosis of surgical disease of the inguinal–femoral region. Surg Gynecol Obstet 152 319–322

    Google Scholar 

  9. LF Horgan JC Shelton DC O’Riordan DP Moore (1996) ArticleTitleStrengths and weaknesses of laparoscopic and open mesh inguinal hernia repair: a randomized controlled experimental study. Br J Surg 83 1463–1467 Occurrence Handle1:STN:280:ByiD1MbptVE%3D Occurrence Handle8944474

    CAS  PubMed  Google Scholar 

  10. M Korenkov A Paul H Troidl (1999) ArticleTitleColor duplex sonography: diagnostic tool in the differentiation of inguinal hernias. J Ultrasound Med 18 565–568 Occurrence Handle1:STN:280:DyaK1MznsVOnuw%3D%3D Occurrence Handle10447083

    CAS  PubMed  Google Scholar 

  11. B Leibl P Däubler J Schwarz M Ulrich R Bittner (1995) ArticleTitleStandardisierte laparoskopische Hernioplastik vs Shouldice-Reparation. Ergebnisse einer randomisierten Studie [in German]. Chirurg 66 895–898 Occurrence Handle1:STN:280:BymD3s7gvVE%3D Occurrence Handle7587563

    CAS  PubMed  Google Scholar 

  12. BJ Leibl CG Schmedt J Schwarz P Däubler K Kraft B Schlossnickel R Bittner (1998) ArticleTitleA single-institution experience with transperitoneal laparoscopic hernia repair. Am J Surg 175 446–452 Occurrence Handle10.1016/S0002-9610(98)00074-9 Occurrence Handle1:STN:280:DyaK1czgslOjsA%3D%3D Occurrence Handle9645770

    Article  CAS  PubMed  Google Scholar 

  13. BJ Leibl CG Schmedt M Ulrich K Kraft R Bittner (1999) ArticleTitleLaparoscopic hernia repair—the facts, but no fashion. Langenbeck’s Arch Surg 384 302–311 Occurrence Handle10.1007/s004230050208 Occurrence Handle1:STN:280:DyaK1MzmsVejuw%3D%3D

    Article  CAS  Google Scholar 

  14. BJ Leibl P Däubler CG Schmedt K Kraft R Bittner (2000) ArticleTitleLong-term results of a randomized clinical trial between laparoscopic hernioplasty and Shouldice repair. Br J Surg 87 780–783 Occurrence Handle10848859

    PubMed  Google Scholar 

  15. BJ Leibl DG Schmedt K Kraft R Bittner (2000) ArticleTitleLaparoskopische transperitoneale Hernioplastik (TAPP) — Effektivität und Gefahren [in German]. Chir Gastroenterol 16 106–109 Occurrence Handle10.1159/000012638

    Article  Google Scholar 

  16. BJ Leibl CG Schmedt K Kraft M Ulrich R Bittner (2000) ArticleTitleScrotal hernias—a contraindication for an endoscopic procedure? Results of a single institution experience in transabdominal preperitoneal repair (TAPP). Surg Endosc 14 289–292 Occurrence Handle1:STN:280:DC%2BD3c3gtlCqtw%3D%3D Occurrence Handle10741451

    CAS  PubMed  Google Scholar 

  17. BJ Leibl CG Schmedt K Kraft M Ulrich R Bittner (2000) ArticleTitleRecurrence after endoscopic transperitoneal hernia repair (TAPP): causes, reparative techniques and results of the reoperation. Am Coll Surg Occurrence Handle1:STN:280:DC%2BD3czivFCjtA%3D%3D Occurrence Handle10873005

    CAS  PubMed  Google Scholar 

  18. WY Leung M Poon TW Fan KW Siu KW Chung WK Kwok CH Kwok (1999) ArticleTitleTesticular volume of boys after inguinal herniotomy: combined clinical and radiological follow-up. Pediatr Surg Int 15 40–41 Occurrence Handle10.1007/s003830050508 Occurrence Handle1:STN:280:DyaK1M7hsF2guw%3D%3D Occurrence Handle9914353

    Article  CAS  PubMed  Google Scholar 

  19. A Moreno-Egea E Girela M Canteras D Martinez JL Aguayo (2000) ArticleTitleAccuracy of clinical diagnosis of inguinal and femoral hernia and its usefulness for indicating laparoscopic surgery. Hernia 4 23–27

    Google Scholar 

  20. D Neuhauser (1977) Elective inguinal herniorrhaphy versus truss in the elderly. JP Bunker BA Barnes F Mosteller (Eds) Costs, risks and benefits of surgery. Oxford University Press New York 223–239

    Google Scholar 

  21. P Renzulli E Frei M Schafer S Werlen H Wegmuller L Krahenbuhl (1997) ArticleTitlePreoperative Nyhus classification of inguinal hernias and type-related individual hernia repair: a case for diagnostic laparoscopy. Surg Laparosc Endopsc 7 373–377 Occurrence Handle10.1097/00019509-199710000-00003 Occurrence Handle1:STN:280:DyaK1c%2FgvFahsw%3D%3D

    Article  CAS  Google Scholar 

  22. IM Rutkow AW Robbins (1993) ArticleTitleDemographic, classification and socioeconomic aspects of hernia repair in the United States. Surg Clin North Am 73 413–426

    Google Scholar 

  23. IM Rutkow AW Robbins (1997) ArticleTitleHernioplastik mit der Netzplombe [in German]. Chirurg 68 970–976 Occurrence Handle10.1007/s001040050305 Occurrence Handle1:STN:280:DyaK1c%2FmsVajuw%3D%3D Occurrence Handle9453905

    Article  CAS  PubMed  Google Scholar 

  24. V Schumpelick G Arlt (1996) ArticleTitleTransinguinale präperitoneale Netzplastik (TIPP) beim Leistenbruch in Lokalanästhesie [in German]. Chirurg 67 419–424 Occurrence Handle10.1007/s001040050099 Occurrence Handle1:STN:280:BymB3s%2FmtlE%3D Occurrence Handle8646931

    Article  CAS  PubMed  Google Scholar 

  25. V Schumpelick KH Treutner G Arlt (1994) ArticleTitleInguinal hernia repair in adults. Lancet 344 375–379 Occurrence Handle1:STN:280:ByuA38fotFA%3D Occurrence Handle7914310

    CAS  PubMed  Google Scholar 

  26. R Stoppa JL Rives C Warlamount JP Palot PJ Verhaege JF Delattre (1984) ArticleTitleThe use of Dacron in the repair of hernias of the groin. Surg Clin North Am 64 269–285 Occurrence Handle1:STN:280:BiuB38vksVI%3D Occurrence Handle6233733

    CAS  PubMed  Google Scholar 

  27. JC Van den Berg JC de Valois PM Go G Rosenbusch (1999) ArticleTitleDetection of groin hernia with physical examination, ultrasound, and MRI compared with laparoscopic findings. Invest Radiol 34 739–743 Occurrence Handle10.1097/00004424-199912000-00002 Occurrence Handle1:STN:280:DC%2BD3c%2FlsFWrsw%3D%3D Occurrence Handle10587869

    Article  CAS  PubMed  Google Scholar 

  28. JC Van den Berg JC de Valois PM Go G Rosenbusch (2000) ArticleTitleRadiological anatomy of the groin region. Eur Radiol 10 661–670 Occurrence Handle10.1007/s003300050980 Occurrence Handle10795551

    Article  PubMed  Google Scholar 

  29. RM Zollinger Jr (1999) ArticleTitleA unified classification for inguinal hernias. Hernia 3 195–200

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to B. M. Kraft.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kraft, B., Kolb, H., Kuckuk, B. et al. Diagnosis and classification of inguinal hernias . Surg Endosc 17, 2021–2024 (2003). https://doi.org/10.1007/s00464-002-9283-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-002-9283-y

Keywords

Navigation