Related Experiment Video
Updated: Jul 10, 2026
Transtubular Endoscopic Posterolateral Decompression for L5-S1 Lumbar Lateral Disc Herniation
Published on: October 14, 2022
Manual Closed Reduction of Incarcerated Hernia: Is It Safe in the Emergency Department?
Yehuda Hershkovitz1,2, Yaniv Zager3,2, Batia Segal3,2
1Department of Surgery, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel.
Background:
Emergency surgical repair is the standard approach to the management of an incarcerated abdominal wall hernia (IAWH). In cases of very high-risk patients, manual closed reduction (MCR) of IAWH may prevent the need for emergency surgery.
Objectives:
To evaluate the safety, success rate, and complications of MCR in the management of IAWH conducted in an emergency department.
Methods:
The data of all patients who underwent MCR between 2012 and 2018 were retrospectively collected. Patient demographics, presenting symptoms, clinical parameters, and management during the hospitalization were retrieved from the medical charts.
Results:
Overall, 548 patients underwent MCR during the study period. The success rate was 25.4% (139 patients). One patient had a complication that required a laparotomy 2 days after his discharge. A recurrent incarceration occurred in 23%, 60% of them underwent successful repeated MCR and the others underwent emergency surgery. Six patients (1.4%) had a bowel perforation after a failed MCR.
Conclusions:
MCR can be performed safely in the emergency department and should be consider as an option to treat IAWH, especially in high operative risk patients.
Insights
Manual closed reduction (MCR) offers a safe option for incarcerated abdominal wall hernias (IAWH), particularly in high-risk patients. This emergency department procedure achieved a 25.4% success rate, potentially avoiding surgery.
Area of Science:
- Abdominal Surgery
- Hernia Management
- Emergency Medicine
Background:
- Incarcerated abdominal wall hernia (IAWH) typically requires emergency surgical repair.
- Manual closed reduction (MCR) presents an alternative for high-risk patients, potentially avoiding surgery.
Purpose of the Study:
- To assess the safety and success rate of MCR for IAWH.
- To identify complications associated with MCR in an emergency department setting.
Main Methods:
- Retrospective collection of data from 548 patients undergoing MCR between 2012 and 2018.
- Analysis of patient demographics, symptoms, clinical parameters, and hospitalization management.
Main Results:
- MCR success rate was 25.4% (139 patients).
- Recurrent incarceration occurred in 23% of patients, with 60% of these successfully managed by repeat MCR.
- A low rate of complications (1.4%) including bowel perforation was observed after failed MCR.
Conclusions:
- MCR is a safe procedure for IAWH management in the emergency department.
- MCR should be considered as a treatment option, especially for high-risk surgical candidates.
More Related Videos
05:15Application of a New Mesh Fixation Method in Laparoscopic Incisional Hernia Repair
Published on: December 23, 2022
04:33Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review
Published on: November 8, 2024