Preface to Video Book of Hernias

Hernias unlike skin cancer, other malignancies and many infections, are a common universal problem. The incidence is not affected by geographic distribution, race, genetics, skin pigmentation, dietary habits, climate or environment.

The optimal treatment for most hernias is operative. The symptoms from which the patient suffers and the risk of obstruction or strangulation influence the decision to operate, as well as the timing of such surgery . The age and health of the patient, the risk involved and the availability of resources may affect the decisions.

The severity of symptoms or the possibility of strangulation must be balanced against the risk of the anaesthetic, the operative or post-operative complications and the long term success of surgical repair.
This module of 7 programs contains 5 on the diagnosis and treatment of inguinal, femoral, epigastric, umbilical and incisional hernias.

There are 2 programs of scrotal conditions and malignant testicular tumours. These are considered with hernias because of the close anatomical and functional relationship with the inguinal canal. It is mandatory to examine the scrotum where any groin hernia is present and conversely, to examine the groin in the presence of any scrotal problem.

Like hernias, the diagnosis of scrotal conditions and testicular tumours is based upon clinical methods without the need to resort to complex investigative procedures.

These programs are not meant to be a definitive text on the subject, but rather a guide to the diagnosis and surgery of common hernias and inguino-scrotal conditions.

The programs can be used in the dissecting room, the tutorial or lecture theatre to demonstrate the anatomical, clinical and operative features simultaneously. The programs can be used as part of a distance education program, for self assessment or peer review programs.

Teaching Methods

The pre-clinical student studies the anatomy of the abdominal wall, inguinal canal, femoral canal and scrotum in great detail.

The Clinical student is taught to apply this, together with the history and demonstration of physical signs to arrive at a precise diagnosis.

The residency staff are required to understand the pre-operative and post-operative care.
The primary care physician should do all this and be able to counsel a patient – patients wish to know the different possibilities.

The primary care physician is also usually responsible for the initial assessment of the degree of urgency, referral for surgical assessment and the decision regarding where and by whom the surgery should be performed.

The surgeon in training is required to develop the clinical skills and operative techniques to deal with hernias.

The nursing staff work side by side and they should be knowledgeable in these different aspects, so they can best administer the care pre-operatively, be part of the surgical team and then give post-operative care.

These programs have been designed to be of benefit to all of these groups.