Andreea Ștefania Racoviță1, D. N. Păduraru1,2, R. M. Mirică 1,3,R. V. Iosifescu1,3
1The University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
23rd Department of General Surgery, The University Emergency Hospital, Bucharest, Romania
3The Department of General Surgery, “Saint John” Clinical Emergency Hospital, Bucharest, Romania
Corresponding author: Radu Mihail Mirica
Phone no. 0040740992324
E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.


Giant inguinal hernias are rare, accounting for only 2,8-5% of all inguinal hernias. Neither its exact etiology nor its treatment resemble a consensus, the main challenge being loss of domain. This is the first full review pertaining to this aspect, according to our knowledge. We performed a review of the English literature using PubMed/Medline, Oxford Journal, Elsevier and Springer libraries. The objective is to present an unbiased picture of giant inguinal hernia management and pitfalls. We found 60 articles that treat this condition, with only one death reported. Comparing between the procedures was difficult because the majority of the publications are case reports or small scale case series. Among the differences, there were some common patterns in view of the popularity of open procedures in both developed and severely limited settings, with a favor for Lichtenstein. Evolution analysis was interesting considering laparoscopic procedures and postoperative aims. Among adjunct procedures, preoperative pneumoperitoneum had the most sustained evolution. Preventing abdominal compartment syndrome and considering unexpected hernia sac contents represented an interesting issue. Acknowledging tissue-targeted gene therapies sets further goals. Elective giant inguinal hernia repair must address a well-planned individualized approach, based on all available evidence and experience. The key to success treatment is not strict adherence to any one technique.

Keywords: giant inguinal hernia, loss of domain, laparoscopic, Lichtenstein, pneumoperitoneum

Wednesday the 21st.