Cisneros MHA, Mayagoitia GJC, Suárez FD

Language: Spanish
References: 13
Page: 163-168
PDF size: 117.45 Kb.

ABSTRACT

Objective: To present a hybrid tension-free inguinal hernioplasty technique, called “from Cisneros”, and the results of its use.
Setting: Third level health care hospital.
Design: Prospective, longitudinal, descriptive and observational study without control group.
Patients and methods: We studied 47 patients subjected to 54 inguinal plasties between July 1998 and December 2001. We included patients from the general surgery outpatient clinic with a diagnosis of inguinal hernia. Surgical technique: Open approach, conventional dissection and invagination of the herniary sac, inserting in the herniary ring a polypropylene cone, fixed with 4 suture points. We placed a polypropylene mesh to strengthen the inguinal floor as described by Lichtenstein. Analyzed variables were: age, gender, site of the hernia, time of evolution, primary or recurring, aggregated diseases, hernia classification, surgical time, hospital stay duration, use of antibiotics, anesthesia, early and late complications, and recurrences.
Results: We operated 40 men and 7 women, their ages ranged from 21 to 90 years: average of 45. 52 primary and 2 recurring hernias. Evolution: 49 less than 5 years and 5 more than 5 years. Site: 25 right, 15 left, and 7 bilateral hernias. Indirect, 34; direct, 16; mixed, 4. Average surgical time was of 40 min. Aggregated diseases were: Diabetes, cardiopathy, hydrocele and obesity. Ninety-six percent of the patients were handled as ambulatory surgery; hospital stay averaged 4 hours. Complications: deep infection, edema of the cord and seroma in one patient each. Late complications at the end of study (41 months): Cutaneous dysesthesia in two cases (3.7%), without recurrences, no perioperative mortality, and return to working activities in an average of 10 days.
Conclusion: The results obtained with the “De Cisneros” hybrid technique indicate that it offers all the advantages of tension free plasties with low morbidity-mortality, virtually eliminating the vulnerable zone of the Mesh-Plug and Lichtenstein techniques. Based on the aforementioned, we consider that this technique will reduce even more the recurrences and might even ablate them completely.

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