2000, Number 4
PDF size: 4. Kb.
ABSTRACTObjetive: To present our experience with inguinal Lichtenstein-type hernioplasty without tension. Seting: Second and third level health care hospitals.
Patients and methods: Prospective report on 103 consecutive patients with inguinal hernia and treated with the Lichtenstein technique using polypropylene mesh, from February 1998 to September 1999. Descriptive statistical analysis.
Results: We studied 95 men and 8 women, aged from 16 to 88 years. The hernia was right sided in 59, left in 44, and bilateral in 13 patients; primary in 95 and recurring in 8. Average evolution time was of 13 months. All surgeries were elective. Peridural anaesthesia was used in 95 patients, general in 8. There were 76 indirect hernias, 25 direct ones, and mixed in 12; average size of the herniary ring was of 3 cm. Average surgical time was of 37 min. Eighty-four patients were treated ambulatory. Two patients developed an important edema of the spermatic cord, which resolved with anti-inflammatory medication. One patient presented infection of the wound (1%) that resolved with drainage and daily cleansing. No recurrence has occurred 18 months after surgery.
Conclusion: This is an easy to perform plasty, somewhat more laborious than the plug-mesh type, but offering a better control of the inguinal floor reinforcement, with low morbidity. If needed, it can be performed bilaterally.
Rutkow IM. Prefacio. Clin Quir Norte Am 1973; 73: XI-XII.
Rutkow IM, Robbins AW. Aspectos demográficos y clasificación en la reparación de hernia en Estados Unidos. Clin Quir Norte Am 1993; 73: 443-58.
Lichtenstein IL, Shulman AG, Amid PK. Causas, prevención y tratamiento de la hernia inguinal recurrente. Clin Quir Norte Am 1973; 73: 567-83.
Deysine M, Soroff HS. Must we specialize herniorraphy for better results? Am J Surg 1990; 160: 239-40; discussion; 240-1.
Deysine M, Grimson RC, Soroff HS. Inguinal herniorrhaphy. Reduced morbidity by service standardization. Arch Surg 1991; 126: 628-30.
Lichtenstein IL, Shulman AG, Amid PK, Montllor MM. The tension-free hernioplasty. Am J Surg 1989; 152: 188-93.
Zamora Reséndiz J. La hernia inguinal: breve repaso de su historia y evolución. Cir Gen 1996; 18: 228-31.
Lichtenstein IL. Herniorraphy. A personal experience with 6,321 cases. Am J Surg 1987; 153: 553-9.
Amid PK, Shulman AG, Lichtenstein IL. Critical scrutiny of the open “tension-free” hernioplasty. Am J Surg 1993; 165: 369-71.
Gilbert AI. Sutureless repair of inguinal hernia. Am J Surg 1992; 163: 331-5.
Robbins AW, Rutkow IM. Mesh plug hernioplasy: the minimally invasive operation. Cir Gen 1998; 20(supl 1): 12-6.
Amid PK. Complications of prosthetic hernia repair. Cir Gen 1998; 20(supl 1): 49-52.
Amid PK. The Lichtenstein open tension-free hernioplasty. Cir Gen 1998; 20(supl 1): 17-20.
Robbins AW, Rutkow IM. Hernioplastia con taponamiento de redecilla. Clin Quir Norte Am 1993; 73: 535-47.