Repair of the giant inguinal hernia: More than mere reduction and reinforcement

Abstract

Inguinal hernia repair is among the most commonly performed surgeries across the globe. Lichenstein’s tension-free technique of open hernioplasty remains the gold-standard, and laparoscopic techniques have gained popularity over recent decade. Giant inguinal hernias that extend below the midpoint of the inner thigh are uncommon, challenging to manage and are more prone for post-operative complications. There is no standard treatment protocol or surgical procedure designated for the management of giant hernias which are associated with grossly disrupted local tissue architecture and compromised tissue integrity and dynamics. Large volumes of omentum and bowel make up the contents of the hernia sac, which with the natural pathological processes involved, further complicate the management. This care report and review of literature aims to elucidate a clear management protocol for Giant Inguinal Hernias.