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

Hernia. 2020 Oct;24(5):937-941. doi: 10.1007/s10029-020-02227-1. Epub 2020 May 29.

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.

Keywords: Incarcerated; Inguinal hernia; Strangulated; Surgery.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Betacoronavirus
  • COVID-19
  • Clinical Decision-Making
  • Conservative Treatment / methods*
  • Coronavirus Infections* / epidemiology
  • Coronavirus Infections* / prevention & control
  • Emergency Medical Services* / methods
  • Emergency Medical Services* / trends
  • Health Services Accessibility / trends
  • Hernia, Inguinal / therapy*
  • Herniorrhaphy / methods*
  • Humans
  • Infection Control / methods
  • Musculoskeletal Manipulations / methods*
  • Pandemics* / prevention & control
  • Pneumonia, Viral* / epidemiology
  • Pneumonia, Viral* / prevention & control
  • SARS-CoV-2
  • Time-to-Treatment / trends*