How safe is taxis in hernia? Reduction of gangrenous omentum - an uncommon occurrence

Garg, Gaurav; Jenaw, Ratnesh; Chaudhary, Siddharth; Garg, Kanchan

doi:10.9790/0853-131135253

Cited by 2 publications

(2 citation statements)

References 2 publications

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“…The effect of such longer acting drugs is unpredictable and the drugs may show unwanted interactions, which are difficult to control [ 22 ]. Nevertheless, diazepam does have some benefits over midazolam for its additional central muscle-relaxant effects which may be of benefit during taxis [ 2 ]. Benzodiazepines are contra-indicated in acute pulmonary insufficiency and marked neuromuscular respiratory weakness.…”

Section: Resultsmentioning

confidence: 99%

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Algorithm for management of an incarcerated inguinal hernia in the emergency settings with manual reduction. Taxis, the technique and its safety

Pawlak

East

Beaux

2021

Hernia

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Background An acute inguinal hernia remains a common emergency surgical condition worldwide. While emergency surgery has a major role to play in treatment of acute hernias, not all patients are fit for emergency surgery, nor are facilities for such surgery always available. Taxis is the manual reduction of incarcerated tissues from the hernia sack to its natural compartment, and can help delay the need for surgery from days to months. The aim of this study was to prepare a safe algorithm for performing manual reduction of incarcerated inguinal hernias in adults. Methods Medline, Scopus, Ovid and Embase were searched for papers related to emergency inguinal hernias and manual reduction. In addition, the British National Formulary and Safe Sedation Practice for Healthcare Procedures: Standards and Guidance were reviewed. Results A safe technique of manual reduction of an acute inguinal hernia, called GPS (Gentle, Prepared and Safe) Taxis, is described. It should be performed within 24 h from the onset of a painful irreducible lump in groin, and when concomitant symptoms and signs of bowel strangulation are absent. Conscious sedation guidelines should be followed. The most popular drug combination is of intravenous morphine and short-acting benzodiazepine, both titrated carefully for optimal and safe effect. The dose of drugs must be individualised, and the smallest effective dosage should be used to avoid oversedation. Following successful taxis, the patient should undergo a short period of observation. Urgent surgery can be undertaken during the same admission or up to several weeks later. Conclusions Taxis is a benign/non-invasive method for patients with an acute, non-strangulated inguinal hernias. It likely reduces the risk and complications of anaesthesia and surgery in the emergency settings. GPS Taxis should be considered as first line treatment in the majority of patients presenting with an acute inguinal hernia when existing bowel infarction is unlikely.

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Section: Resultsmentioning

confidence: 99%

“…Taxis was first discussed in the fourth century B.C. by the Greek Praxagoras of Cas [ 2 ]. Since then, a number of techniques have been described, but these appear to no longer be performed frequently, particularly in developed countries.…”

Section: Introductionmentioning

confidence: 99%

Algorithm for management of an incarcerated inguinal hernia in the emergency settings with manual reduction. Taxis, the technique and its safety

Pawlak

East

Beaux

2021

Hernia

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Current opinions in inguinal hernia emergencies: A comprehensive review of related evidences

Kulaçoğlu¹

2023

IJAWHS

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INTRODUCTION: Groins hernia emergencies are evaluated under two definitions: incarceration that is defined as a hernia in which its content becomes irreducible at the passage in the abdominal wall and strangulation that compromises the blood supply to the omentum and/or intestines within the hernia sac. The purpose of this paper was to determine the latest knowledge about groin hernia emergencies. MATERIALS AND METHODS: PubMed and Google Scholar searches were done by using combinations of “inguinal hernia” and “emergency”, and “groin hernia” and “emergency” keywords at first. More detailed searches were performed to enrich the “Surgical treatment” part of the paper by using “emergency hernia” and “mesh”, “emergency hernia,” and “laparoscopic versus open” keywords afterward. RESULTS: Approximately 5%–10% of all inguinal repairs are performed in emergency settings. Both lateral and medial inguinal hernias can get incarcerated or strangulated, whereas the risk for femoral hernias is higher. Manual reduction of incarcerated inguinal hernias is successful in approximately 60% of the cases. The prediction of bowel ischemia due to strangulation may be possible with some blood tests and imaging studies like ultrasound and computed tomography. It has been shown that the longer the duration of incarceration the higher the risk of bowel ischemia. Bowel resection which is more frequently necessary in patients with advanced age, female gender, and femoral hernia, is associated with an increased risk of perioperative mortality. Some surgeons still use tissue-suture repairs in an emergency setting; however, mesh repairs have been shown to be safe unless there is an overt contamination. CONCLUSION: Early treatment of complicated groin hernias is the key to favorable outcomes. The need for bowel resection and advanced age are the most prominent factors for morbidity and mortality. Mesh repairs are safe in most cases. Minimally invasive approaches promise good results in experienced centers.

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How safe is taxis in hernia? Reduction of gangrenous omentum - an uncommon occurrence

Cited by 2 publications

References 2 publications

Algorithm for management of an incarcerated inguinal hernia in the emergency settings with manual reduction. Taxis, the technique and its safety

Algorithm for management of an incarcerated inguinal hernia in the emergency settings with manual reduction. Taxis, the technique and its safety

Current opinions in inguinal hernia emergencies: A comprehensive review of related evidences

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