Patrick M Chesley1, George E Black1, Matthew J Martin1, Eric K Johnson1, Justin A Maykel2, Scott R Steele3. 1. Department of Surgery, Madigan Army Medical Center, Ft. Lewis, WA, USA. 2. Department of Surgery, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA, USA. 3. Department of Surgery, Madigan Army Medical Center, Ft. Lewis, WA, USA. Electronic address: harkersteele@mac.com.
Abstract
BACKGROUND: Pathological examination of hernia sac specimens adds additional steps and cost to a surgical procedure but has no proven benefit. Although well studied in pediatrics, there are limited data in the adult literature pertaining to this practice. METHODS: This is a retrospective analysis from a single institution referral center over a 4-year period (2007 to 2011). All inguinal, incisional, ventral, and umbilical hernia repairs greater than 18 years of age were included. RESULTS: A total of 1,216 inguinal (55.4%), incisional (11.4%), umbilical (21.5%), or ventral hernia (11.7%) repairs were included. In 246 cases (20.2%), hernia sac specimens were sent to pathology (open 96.7%; laparoscopic 3.3%). There were no cases in which management of the patient changed because of the final results. CONCLUSION: The rarity of changes in diagnosis and treatment from routine pathologic examination of a hernia sac does not justify this practice and indicates that it may be omitted except in unique circumstances. Published by Elsevier Inc.
BACKGROUND: Pathological examination of hernia sac specimens adds additional steps and cost to a surgical procedure but has no proven benefit. Although well studied in pediatrics, there are limited data in the adult literature pertaining to this practice. METHODS: This is a retrospective analysis from a single institution referral center over a 4-year period (2007 to 2011). All inguinal, incisional, ventral, and umbilical hernia repairs greater than 18 years of age were included. RESULTS: A total of 1,216 inguinal (55.4%), incisional (11.4%), umbilical (21.5%), or ventral hernia (11.7%) repairs were included. In 246 cases (20.2%), hernia sac specimens were sent to pathology (open 96.7%; laparoscopic 3.3%). There were no cases in which management of the patient changed because of the final results. CONCLUSION: The rarity of changes in diagnosis and treatment from routine pathologic examination of a hernia sac does not justify this practice and indicates that it may be omitted except in unique circumstances. Published by Elsevier Inc.