# Femoral Hernia — GCMD Library living collection

Everything in the library about femoral hernia — built automatically from dossiers that name it.

Updated: n/a · 1 episodes · 18 cited statements

## Episodes
### In-Depth Reviews
- [Inguinal Hernia With M. Rosen](https://qa.library.globalcastmd.com/watch/inguinal-hernia-with-m-rosen-13756) — podcast · 31:05 · [machine version](https://qa.library.globalcastmd.com/watch/inguinal-hernia-with-m-rosen-13756.md)

## Chapters
- [0:00](https://qa.library.globalcastmd.com/watch/inguinal-hernia-with-m-rosen-13756?t=0) Asymptomatic Hernias and Watchful Waiting (Ep 1)
- [5:00](https://qa.library.globalcastmd.com/watch/inguinal-hernia-with-m-rosen-13756?t=300) High-Risk Patients and Non-Operative Management (Ep 1)
- [7:55](https://qa.library.globalcastmd.com/watch/inguinal-hernia-with-m-rosen-13756?t=475) Selecting Operative Approach: Open versus Laparoscopic (Ep 1)
- [13:52](https://qa.library.globalcastmd.com/watch/inguinal-hernia-with-m-rosen-13756?t=832) Contraindications and Patient Selection for Laparoscopy (Ep 1)
- [17:06](https://qa.library.globalcastmd.com/watch/inguinal-hernia-with-m-rosen-13756?t=1026) Laparoscopic Technique and Mesh Placement (Ep 1)
- [23:43](https://qa.library.globalcastmd.com/watch/inguinal-hernia-with-m-rosen-13756?t=1423) Mesh Selection and Fixation (Ep 1)
- [25:18](https://qa.library.globalcastmd.com/watch/inguinal-hernia-with-m-rosen-13756?t=1518) Open Repair Techniques and Femoral Hernias (Ep 1)
- [28:04](https://qa.library.globalcastmd.com/watch/inguinal-hernia-with-m-rosen-13756?t=1684) Special Scenarios: Recurrent, Bilateral, and Incarcerated Hernias (Ep 1)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- "In Fitzgibbons' VA study of minimally symptomatic to asymptomatic hernias in patients in their 70s-80s, the risk of presenting with an emergency problem requiring operation due to incarceration or strangulation was less than 1% (actually one-third of 1%)." — Michael Rosen (epidemiological) [Ep 1 · 3:22](https://qa.library.globalcastmd.com/watch/inguinal-hernia-with-m-rosen-13756?t=202)
- "In Fitzgibbons' original two-year VA study, almost one-third of patients in the observation group went on to develop symptoms and need an operation." — Michael Rosen (epidemiological) [Ep 1 · 4:00](https://qa.library.globalcastmd.com/watch/inguinal-hernia-with-m-rosen-13756?t=240)
- "In long-term follow-up of Fitzgibbons' VA study patients (approximately five years), almost three-quarters of patients developed symptoms requiring repair." — Michael Rosen (epidemiological) [Ep 1 · 4:20](https://qa.library.globalcastmd.com/watch/inguinal-hernia-with-m-rosen-13756?t=260)
- "The learning curve for laparoscopic inguinal hernia repair is real, with some studies showing 200 to 250 cases required." — Michael Rosen (clinical) [Ep 1 · 8:40](https://qa.library.globalcastmd.com/watch/inguinal-hernia-with-m-rosen-13756?t=520)
- "In laparoscopic inguinal hernia repair, mesh is placed away from the nerves, and the risk of chronic pain when done correctly is lower than in open inguinal hernias." — Michael Rosen (clinical) [Ep 1 · 9:20](https://qa.library.globalcastmd.com/watch/inguinal-hernia-with-m-rosen-13756?t=560)
- "Laparoscopic repair offers approximately one week to 10 days earlier recovery compared to open repair, not a month or three to four months." — Michael Rosen (clinical) [Ep 1 · 12:10](https://qa.library.globalcastmd.com/watch/inguinal-hernia-with-m-rosen-13756?t=730)
- "The most important part of any laparoscopic repair is parietalization of the cord (stripping the peritoneum off the cord inferiorly and posteriorly), a principle promoted by Rene Stoppa during open preperitoneal repairs." — Michael Rosen (clinical) [Ep 1 · 18:20](https://qa.library.globalcastmd.com/watch/inguinal-hernia-with-m-rosen-13756?t=1100)
- "The risk of recurrence in laparoscopic repair is the peritoneum coming under the mesh and then going back out to the defect inferiorly." — Michael Rosen (clinical) [Ep 1 · 18:40](https://qa.library.globalcastmd.com/watch/inguinal-hernia-with-m-rosen-13756?t=1120)
- "According to Stoppa's original descriptions, for a unilateral inguinal hernia repair, one should never use less than a 15 by 15 centimeter piece of mesh (or 6 by 6 inch), which is much bigger than the vast majority of laparoscopic preformed meshes being placed." — Michael Rosen (clinical) [Ep 1 · 20:00](https://qa.library.globalcastmd.com/watch/inguinal-hernia-with-m-rosen-13756?t=1200)
- "Heavyweight mesh is approximately 90 grams per meter squared (Marlex or Prolene mesh), midweight mesh is 40-50 grams per meter squared, and lightweight mesh (Ultrapro) is less than 30 grams per meter squared." — Michael Rosen (clinical) [Ep 1 · 21:20](https://qa.library.globalcastmd.com/watch/inguinal-hernia-with-m-rosen-13756?t=1280)
- "The advantage of lighter weight mesh is less foreign body and potentially less contraction due to better ingrowth; the disadvantage is half the material, which in direct hernias where muscles never come back together puts the mesh at risk for fracturing." — Michael Rosen (clinical) [Ep 1 · 22:00](https://qa.library.globalcastmd.com/watch/inguinal-hernia-with-m-rosen-13756?t=1320)
- "There is no evidence that absorbable fixation causes reduction in pain, better fixation, or improved long-term outcomes compared to permanent fixation." — Michael Rosen (clinical) [Ep 1 · 24:09](https://qa.library.globalcastmd.com/watch/inguinal-hernia-with-m-rosen-13756?t=1449)
- "If absorbable fixation is put through a nerve, it is the neuroma that causes the problem, not the tack itself." — Michael Rosen (clinical) [Ep 1 · 24:20](https://qa.library.globalcastmd.com/watch/inguinal-hernia-with-m-rosen-13756?t=1460)
- "There is mounting evidence that medium-weight polypropylene mesh can be placed in a contaminated field, with several series demonstrating this in ventral hernias." — Michael Rosen (clinical) [Ep 1 · 24:56](https://qa.library.globalcastmd.com/watch/inguinal-hernia-with-m-rosen-13756?t=1496)
- "For incarcerated femoral hernias, the lacunar ligament can be released medially to gain an extra centimeter of space for reduction without destroying the inguinal floor or inguinal ligament." — Michael Rosen (clinical) [Ep 1 · 27:00](https://qa.library.globalcastmd.com/watch/inguinal-hernia-with-m-rosen-13756?t=1620)
- "For recurrent hernias, the surgeon should go where nobody has been before; if somebody has been in both places, go where you are best." — Michael Rosen (opinion) [Ep 1 · 28:12](https://qa.library.globalcastmd.com/watch/inguinal-hernia-with-m-rosen-13756?t=1692)
- "For bilateral hernias in a skilled laparoscopic surgeon, laparoscopy is the best approach." — Michael Rosen (opinion) [Ep 1 · 28:30](https://qa.library.globalcastmd.com/watch/inguinal-hernia-with-m-rosen-13756?t=1710)
- "Surgeons learning laparoscopic inguinal hernia repair should avoid bilateral and recurrent hernias during their learning curve, although these patients might benefit most, they have the highest risk." — Michael Rosen (opinion) [Ep 1 · 28:40](https://qa.library.globalcastmd.com/watch/inguinal-hernia-with-m-rosen-13756?t=1720)

## Changelog
- Sep 7: 3 items added automatically

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