Vol 5, No 3 (2003)
Published online: 2003-10-07
Inguinal hernia repair using own surgical technique - results of 500 operative procedures
Chirurgia Polska 2003;5(3):145-153.
Abstract
Background: This paper presents the results of patients with inguinal hernias treated with our own surgical technique.
Material and methods: 500 patients were subjected to inguinal hernia repair. The basic element of inguinal canal reconstruction was the pediculate fascial flap collected from the medial branch of the aponeurosis of the external oblique abdominal muscle, which strengthens preperitoneally the posterior wall of the inguinal canal according to the Stoppa, Nyhus technique. The next element strengthening that wall, is the lateral branch of the aponeurosis of the external oblique abdominal muscle, which transferred subfunicularly, reinforces the transverse fascia in accordance with the Lichtenstein technique. Patients with a transverse fascia markedly damaged, with wide ring hernias (over 4 cm in diameter) and recurrent hernias were deemed to be qualified for surgery.
Results: A follow up period ranging from 15 to 66 months revealed 3.6% in hernia recurrences. Other complications included: wound suppuration or haematoma, transient swelling of the testis, disorders of superficial sensibility around the surgical wound, epididymitis, and funicular hydrocele. They were observed in 10% of the patients and were transitory. In one case, the urinary bladder was damaged intra-operatively and in another, femoral neuralgia developed.
Conclusions: The operative technique suggested for use by us strengthens the inguinal canal without causing tension, enables high ligation of the oblique hernia sac with proper sealing and narrowing of the deep inguinal ring. Used in a group with a higher risk of recurrence, it resulted in good early (easy ambulation) and late results.
Material and methods: 500 patients were subjected to inguinal hernia repair. The basic element of inguinal canal reconstruction was the pediculate fascial flap collected from the medial branch of the aponeurosis of the external oblique abdominal muscle, which strengthens preperitoneally the posterior wall of the inguinal canal according to the Stoppa, Nyhus technique. The next element strengthening that wall, is the lateral branch of the aponeurosis of the external oblique abdominal muscle, which transferred subfunicularly, reinforces the transverse fascia in accordance with the Lichtenstein technique. Patients with a transverse fascia markedly damaged, with wide ring hernias (over 4 cm in diameter) and recurrent hernias were deemed to be qualified for surgery.
Results: A follow up period ranging from 15 to 66 months revealed 3.6% in hernia recurrences. Other complications included: wound suppuration or haematoma, transient swelling of the testis, disorders of superficial sensibility around the surgical wound, epididymitis, and funicular hydrocele. They were observed in 10% of the patients and were transitory. In one case, the urinary bladder was damaged intra-operatively and in another, femoral neuralgia developed.
Conclusions: The operative technique suggested for use by us strengthens the inguinal canal without causing tension, enables high ligation of the oblique hernia sac with proper sealing and narrowing of the deep inguinal ring. Used in a group with a higher risk of recurrence, it resulted in good early (easy ambulation) and late results.
Keywords: inguinal herniaaponeurosisfascial flapnew technique
