Majority of authors agree that a normal appendix within the hernial sac does not require appendectomy.
We conclude that the presence of the appendix in an inguinal hernial sac referred to as "Amyand's hernia", is an uncommon entity.
Sometimes the presenting features of an inflamed appendix may alert the surgeon to this possibility but it is a rarity and, is almost always misdiagnosed as an incarcerated hernia with diagnosis confirmed upon opening of the hernial sac
In addition, surgical manipulation to achieve visualization of the entire appendix and its base by enlarging the hernial defect or distending the neck of the hernial sac increases the possibility of recurrence by weakening the anatomic structures around the defect.
If a scrotal abscess is present, this usually indicates that the appendix in the hernial sac is perforated.
Diagnosis of tuberculosis was unexpected and was made because of the routine practice of sending all hernial sacs for histopathological examination.
5] Dormant tuberculosis and hidden malignancies of gastrointestinal tract were incidentally detected by examination of the hernial sacs which would have been otherwise unnoticed for a longer period.
The cremaster was incised and the cord structures and hernial sac
were dissected from it by blunt and sharp dissection.
The conventional technique for undesended testis repair is high ligation of the hernial sac
after proper dissection upto the deep ring, Mohta et al.
Hernia approached with Left Inguinal incision, indirect hernial sac
noticed and sac was carefully dissected separating it from cord structures.
Indirect hernial sac
was identified and isolated all around.
On exploration, hernial sac
containing uterus with fallopian tubes, upper vagina, and testes were present.
Xiang et al (10) They conducted randomized, double-blinded clinical trial, with aim to examine whether supplementation of caudal bupivacaine with dexmedetomidine can eliminate the responses to hernial sac
traction & to study the perioperative effects of dexmedetomidine in pediatric patients.
The diagnosis is even more difficult in obese people where in the hernial sac
may lie in an intraparietal plane masked by abdominal subcutaneous fat (3).
Always search for the avascular plane between the adhesions and the abdominal wall or the hernial sac