The utility of pathologic evaluation of adult hernia specimens.
BACKGROUND
Pathological examination of hernia sac specimens adds additional steps and cost to a surgical procedure but has no proven benefit. Although well studied in pediatrics, there are limited data in the adult literature pertaining to this practice.


METHODS
This is a retrospective analysis from a single institution referral center over a 4-year period (2007 to 2011). All inguinal, incisional, ventral, and umbilical hernia repairs greater than 18 years of age were included.


RESULTS
A total of 1,216 inguinal (55.4%), incisional (11.4%), umbilical (21.5%), or ventral hernia (11.7%) repairs were included. In 246 cases (20.2%), hernia sac specimens were sent to pathology (open 96.7%; laparoscopic 3.3%). There were no cases in which management of the patient changed because of the final results.


CONCLUSIONS
The rarity of changes in diagnosis and treatment from routine pathologic examination of a hernia sac does not justify this practice and indicates that it may be omitted except in unique circumstances.
Department of Surgery, Madigan Army Medical Center, Ft. Lewis, WA, USA.
Patrick M
PM
Chesley
Department of Surgery, Madigan Army Medical Center, Ft. Lewis, WA, USA.
George E
GE
Black
Department of Surgery, Madigan Army Medical Center, Ft. Lewis, WA, USA.
Matthew J
MJ
Martin
Department of Surgery, Madigan Army Medical Center, Ft. Lewis, WA, USA.
Eric K
EK
Johnson
Department of Surgery, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA, USA.
Justin A
JA
Maykel
Department of Surgery, Madigan Army Medical Center, Ft. Lewis, WA, USA. Electronic address: harkersteele@mac.com.
Scott R
SR
Steele
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D006547:Hernia / Q000473:pathology*; D059685:Herniorrhaphy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013048:Specimen Handling / Q000706:statistics & numerical data*; D055815:Young Adult
Hernia sac; Herniorrhaphy; Pathology; Specimen