Author/Editor		Rakovec, S
Title		Odprti nenapetostni postopki oskrbe dimeljskih kil
Translated title		The open tension-free inguinal hernia repair
Type		članek
Source		In: Repše S, editor. Zbornik simpozija Kile; 1998; Ljubljana. Ljubljana: Kirurška šola, Kirurška klinika,
Publication year		1998
Volume		str. 90-107
Language		slo
Abstract		All old techniques of herniorrhaphy involve approximation of tissues under tension, which accounts for their unreliability. Therefore the recovery time is long and the recurrence rate unacceptably high. The new methods using a mesh patch of polypropylene allow for a tension-free repair, which is much more reliable. So they are associated with a shorter recovery time and carry a low probability of recurrence. The tension-free repair can be accomplished in an open manner, by placing the mesh through an open incision, or by the endoscopic technique, which involves placing the mesh from within by laparoscopic instruments. The open tension-free procedures can be performed with the use of stitches (according to Lichtenstein) or without them (sutureless techniques). Stiching the mesh may cause problems due to maldistribution of tension between the mesh and the patients tissues, the occurrence of neuralgia or the development of inflammatory granuloma. Therefore sutureless procedures are increasingly performed. They usually require, besides the use of a mesh patch, also the use of a dart plug made of the same material. Open tension-free methods of hernia repair have been used at our Department since 1994. The first 77 operations were performed by Lichtenstein technique. The mean postoperative hospital stay was 3.4 days and the mean workrestriction period was 4 weeks. Serious complications wre noted in six patients: bleeding in one, long- lasting neuralgia in two, and purulent granuloma, appearing long after discharge from hospital, in three. There were no recurrences. In the middle of the year 1995, we shifted to Trabuccos sutureless technique. By the end of the year 1997, we had performed 353 operations.(Abstract truncated at 2000 characters)
Descriptors		HERNIA, INGUINAL SURGICAL MESH POLYPROPYLENES SUTURE TECHNIQUES