A manual reduction of hernia under analgesia/sedation (Taxis) in the acute inguinal hernia: a useful technique in COVID-19 times to reduce the need for emergency surgery—a literature review

Abstract

Background Acute IH is a common surgical presentation. Despite new guidelines being published recently, a number of important questions remained unanswered including the role of taxis, as initial non-operative management. This is particularly relevant now due to the possibility of a lack of immediate surgical care as a result of COVID-19. The aim of this review is to assess the role of taxis in the management of emergency inguinal hernias. Methods A review of the literature was undertaken. Available literature published until March 2019 was obtained and reviewed. 32,021 papers were identified, only 9 were of sufficient value to be used. Results There was a large discrepancy in the terminology of incarcerated/strangulated used. Taxis can be safely attempted early after the onset of symptoms and is effective in about 70% of patients. The possibility of reduction en-mass should be kept in mind. Definitive surgery to repair the hernia can be delayed by weeks until such time as surgery can be safely arranged. Conclusions The use of taxis in emergency inguinal hernia is a useful first line of treatment in areas or situations where surgical care is not immediately available, including the COVID-19 pandemic. Emergency surgery remains the mainstay of management in the strangulated hernia setting.

Effects of COVID-19 pandemic on general surgical emergencies: are some emergencies really urgent? Level 1 trauma center experience

“…De Simone et al [ 20 ] reported that non-operative approach can be applied acute appendicitis, acute cholecystitis, adhesive small bowel obstructions and incarcerated hernias in pandemic period. East et al [ 21 ] reported that the use of taxis procedure (a manual reduction of hernia under analgesia/sedation) for incarcerated inguinal hernia is a useful first-line treatment in situations where surgical care is not immediately available, including the COVID-19 pandemic. In this study, there was a severe decrease in the number of these patients who were recommended nonoperative follow-up in recent publications during pandemic.…”

Emergency high ligation in a suspected COVID-19 pediatric patient with incarcerated inguinal hernia: A case report

“…Manual reduction is standard treatment for incarcerated inguinal hernia in children. Moreover, this technique is very useful to decrease the need for any emergency procedure during the COVID-19 pandemic [ 7 ]. However, manual reduction is not without some risks.…”

The Effect of the COVID Pandemic Lockdown Measures on Surgical Emergencies: Experience and Lessons Learned from A Greek Tertiary Hospital.

“…De Simone et al [11] reported that non-operative treatment could be applied in acute appendicitis, acute cholecystitis, adhesive bowel obstructions, and incarcerated hernias in the period of the pandemic. East et al [12] reported that a manual reduction of incarcerated hernias under analgesia or sedation is a useful rst treatment in situations where surgical management is not immediately available, including the Covid-19 pandemic. Simultaneously, a reasonable decrease in road tra c accidents was encountered due to the population's tra c limitations.…”