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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Laparoscopic inguinal herniorrhaphy was performed on 76 patients with a total of 82 hernias. A modified Schultz repair was done using a mushroom-shaped mesh plug. The flat piece of this plug acts as a stopper to prevent migration of the plug into the inguinal canal or the subcutaneous tissue (in the direct hernia, primary or recurrent). Average operative time was 69 min (range 42-140 min). Short-term follow-up of 1 to 7 months showed no recurrence and good acceptance of the repair by patients.
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PMID:Laparoscopic inguinal herniorrhaphy: the mushroom plug repair. 134 14

The success of the laparoscopic cholecystectomy was remarkable and well-founded, thus it seems necessary to examine whether this procedure could be also used for other general surgical operations. Since Dec. 29th, 1990 the transperitoneal repair of hernias by laparoscopy has been performed in 177 patients. The patients were followed up in regular intervals. The first 100 patients were treated with the "plug repair" technique of Schultz and Corbitt. In this group one recurrence (4 month after operation) and one dislocation of a mesh roll (2 weeks after the operation) were observed. In the middle of April 92 we changed the laparoscopic operation technique to a preperitoneal mesh fortification analogous to the procedure of Stoppa. This requires a detailed preparation of all possible positions of the hernia (medial and lateral compartment). A cutting through all layers of the abdominal wall can be avoided. After the preparation all abdominal wall defects can be fortified effectively and clearly. In this group we have treated 77 patients, so far without complications. With the exception of scrotal hernias and adhesions the laparoscopic hernioplastique can be used in any indication of inguinal hernia repair. An evaluation of the long-term results can only be performed in the future although the early results are encouraging.
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PMID:[Critical evaluation of laparoscopic hernia surgery]. 814 49

Hernia (Greek kele/hernios--bud or offshoot) was present in the human history from its very beginning. The role of surgery was restricted to the treatment of huge umbilical and groin hernias and life-threatening incarcerated hernias. The treatment of groin hernia can be divided into five eras. The oldest epoch was ancient era from ancient Egypt to 15th century. The Egyptian Papirus of Ebers contains description of a hernia: swelling that comes out during coughing. Most essential knowledge concerning hernias in ancient times derives from Galen. This knowledge with minor modifications was valid during Middle Ages and eventually in the Renaissance the second era of hernia treatment began. Herniology flourished mainly due to many anatomical discoveries. In spite of many important discoveries from 18th to 19th century the treatment results were still unsatisfactory. Astley Cooper stated that no disease treated surgically involves from surgeon so broad knowledge and skills as hernia and its many variants. Introduction of anesthesia and antiseptic procedures constituted the beginning of modern hernia surgery known as era of hernia repair under tension (19th to middle 20th century). Three substantial rules were introduced to hernia repair technique: antiseptic and aseptic procedures. high ligation of hernia sac and narrowing of the internal inguinal ring. In spite of the progress the treatment results were poor. Recurrence rate during four years was ca. 100% and postoperative mortality gained even 7%. The treatment results were satisfactory after new surgical technique described by Bassini was implemented. Bassini introduced the next rule of hernia repair ie. reconstruction of the posterior wall of inguinal canal. The next landmark in inguinal hernia surgery was the method described by Canadian surgeon E. Shouldice. He proposed imbrication of the transverse fascia and strengthening of the posterior wall of inguinal canal by four layers of fasciae and aponeuroses of oblique muscles. These modifications decreased recurrence rate to 3%. The next epoch in the history of hernia surgery lasting to present days is referred to as era of tensionless hernia repair. The tension of sutured layers was reduced by incisions of the rectal abdominal muscle sheath or using of foreign materials. The turning point in hernia surgery was discovery of synthetic polymers by Carothers in 1935. The first tensionless technique described by Lichtenstein was based on strengthening of the posterior wall of inguinal canal with prosthetic material. Lichtenstein published the data on 1,000 operations with Marlex mesh without any recurrence in 5 years after surgery. Thus fifth rule of groin hernia repair was introduced--tensionless repair. Another treatment method was popularized by Rene Stoppa, who used Dacron mesh situated in preperitoneal space without fixing sutures. First such operation was performed in 1975, and reported recurrence rates were quite low (1.4%). The next type of repair procedure was sticking of a synthetic plug into inguinal canal. Lichtenstein in 1968 used Marlex mesh plug (in shape of a cigarette) in the treatment of inguinal and femoral hernias. The mesh was fixated with single sutures. The next step was introduction of a Prolene Hernia System which enabled repair of the tissue defect in three spaces: preperitoneal, above transverse fascia and inside inguinal canal. Laproscopic treatment of groin hernias began in 20th century. The first laparoscopic procedure was performed by P. Fletcher in 1979. In 1990 Schultz plugged inguinal canal with polypropylene mesh. Later such methods like TAPP and TEP were introduced. The disadvantages of laparoscopic approach were: high cost and risk connected with general anesthesia. In conclusion it may be stated that history of groin hernia repair evolved from life-saving procedures in case of incarcerated hernias to elective operations performed within the limits of 1 day surgery.
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PMID:[The history of treatment of groin hernia]. 1914 Apr 92

The evolution of a preferred technique for laparoscopic inguinal hernia repair has been occurring over the past several years. The early work of Ger involved a stapled closure of the dilated internal ring using a specialized 12-mm. instrument, which combined the functions of tissue approximation and stapling. This was followed by a prosthetic mesh plug technique of Schultz and Corbitt, which consisted of a free mesh plug occlusion of the inguinal canal, combined with prosthetic patch coverage of the hernia defect.
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PMID:Extraperitoneal laparoscopic hernia repair: experience in 178 patients. 2131 91