Gilbert Classification Of Inguinal Hernia
In 1993 rutkow and robbins added a type 6 to the gilbert classification to designate double inguinal hernias and a type 7 to designate a femoral hernia.
Gilbert classification of inguinal hernia. Iiib large indirect hernia with large dilated internal ring with medical expansion and encroachment of posterior direct floor inguinal wall. 1 department of surgery university of miami school of medicine coral gables florida. Iiv c femoral hernia. Gilbert ai 1989 an anatomic and functional classification for the diagnosis and treatment of inguinal hernia.
We suggest a herniating preperitoneal lipoma or. 1 indirect snug. Some of these classifications include casten 1967 halverson and mcvay 1970 gilbert 1989 nyhus 1991 bendavid 1993 aachen also known as the. And arregui 2003.
50 classification of inguinal hernia 3. 3 indirect ring 2 fingerbreadths. An anatomic and functional classification for the diagnosis and treatment of inguinal hernia. Several hernia classification sys tems which were related to the pathogenesis of her nia have been developed to support the surgeon in the hernia repair and to alleviate a comparison be tween the different techniques of hernia repair.
Am j surg 157 331 333 crossref pubmed google scholar gilbert ai 1997 symposium on the management of inguinal hernias. Posterior wall of the inguinal canal 14 or the presence of a cord lipoma 15. In 1971 medicare discharges for inguinal hernia without intestinal obstruction showed that 94 of patients had surgery with a probability of death of 0 005 five per 100 000. It also occurs in adolescence or adult life.
In 1989 gilbert published a classification system based. However for inguinal hernia with obstruction 88 underwent surgery with a death rate of 0 05 a ten fold increased risk of death. These two aspects may nonethe less be important in the repair of an inguinal hernia especially if they were not recognised and as a conse quence not treated leading to an early pseudo recur rence. Numerous classifications for inguinal hernias have been described and proposed to allow surgeons to define the anatomical type of hernia and to match the repair to the defect found.
Nyhus 28 developed a classification designed for the posterior approach based on the size of the internal ring and the integrity of the posterior wall. In 1988 gilbert described a detailed classification system based on anatomic and functional defects established intraoperatively namely the presence or absence of a hernia sac the size and competency of the internal ring and the integrity of the transversalis fascia transversus abdominis aponeurosis layer posterior wall within hesselbach s triangle6 7. 4 direct disruption of entire direct floor. The testis appears to lie within the lower part of the hernia russel et al 2004.