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

The technical problems, early complications and short-term results of a tension-free method of 1098 inguinal hernia repairs in 1017 patients have been assessed. The operation was conducted under local anaesthesia, and the inguinal canal floor was reinforced by a polypropylene mesh. Patients were discharged home the same day. There was no mortality, no urinary complications and one case of venous thrombosis. There was one recurrence after a primary hernia repair and two patients have developed recurrences after repair of a recurrent hernia. The overall sepsis rate was 0.9% and 1% of patients had persistent neuralgia. No prosthesis required removal. In all, 49.6% of office workers returned to work in 1 week or less and 61% of manual workers in 2 weeks or less. The major advantages of the tension-free mesh repair under local anaesthesia are simplicity, substantial cost savings and very low rates of complications.
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PMID:Tension-free mesh hernia repair: review of 1098 cases using local anaesthesia in a day unit. 854 Jun 80

Laparoscopic hernia repair has a number of unique potential complications. These include complications of pneumoperitoneum, general anesthesia, trocar injuries and complications of small bowel obstruction related to trocar site fascial defects, intraabdominal adhesions, and reaction with the synthetic mesh. A totally extraperitoneal approach should, in theory, eliminate postoperative small bowel obstruction in that the peritoneal space is never entered. A case of small bowel obstruction following totally extraperitoneal-preperitoneal herniorrhaphy is presented.
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PMID:Small bowel obstruction following endoscopic extraperitoneal-preperitoneal herniorrhaphy. 757 82

Traditional open hernia repairs are usually performed as outpatient procedures under local anesthesia, with minimal morbidity and low recurrence rates. To be widely accepted, any new procedure must at least match current standards of performance. This review summarizes the most widely used techniques for laparoscopic inguinal herniorrhaphy. Early results of over 1700 cases using these techniques are reported. Recurrence was lowest using the total extraperitoneal repair. In selected patients, laparoscopic inguinal herniorrhaphy is a safe and comparable alternative to standard open repairs.
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PMID:Laparoscopic inguinal herniorrhaphy. 758 68

The patient was a 94-year-old woman. She was admitted on our hospital for ileus due to incarceration of a right femoral hernia on October 29, 1993. Although an emergency operation was necessary she refused, therefore we continued to have conservative therapy. After repeated persuasion, she agreed the operation which was performed under spinal anesthesia on November 17. The peritoneal cavity was opened through a transverse incision of the lower abdomen. Some bloody ascites was encountered. Part of the jejunum was incarcerated through right femoral canal and was completely obstructed, with ischemic but no necrotic changes. It was excised. She resumed oral intake on the 7th postoperative day and was discharged on the 77th postoperative day. Initially due to her opposition we could not perform the operation, but after persistent persuasion she agreed and survived. Good communications between the doctor and the patient, and of course informed consent, was very important in such cases.
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PMID:[A case of incarceration of a right femoral hernia in a very old female with a intriguing clinical course]. 761 82

The Lichtenstein plug is a cylindric polypropylene prosthesis by which small recurrent inguinal hernias can be occluded without a formal hernia repair. In a series of 245 recurrent inguinal hernia repairs from 1990 to 1994, the Lichtenstein plug was used for 55 hernias, 22.4% of all recurrencies. Early postoperative complications concerned two hematomas and one sinus formation. Re-recurrence was 3.6% (n = 2/55) after a median follow-up of 30 months. Both recurrencies could again be repaired under local anesthesia. For stage I and II recurrencies the Lichtenstein plug is the least invasive procedure and completes the operative armamentarium to the advantage of patients.
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PMID:[The Lichtenstein plug method for repair of recurrent inguinal hernia. Indications, technique and results]. 763 55

This study documents the results obtained in 30 day patients undergoing open hernia repair under local infiltration block with patient-controlled sedation (group A) and 29 day patients undergoing laparoscopic hernia repair under general anaesthesia (group B). The mean operating time was less in group A (44.8 min) compared with group B (66.6 min) (p < 0.0001). Similarly, stage 1 recovery room times were longer in group B (98.1 min) than group A (45.1 min) (p < 0.0001). Time to discharge for group A (139.1 min) was significantly shorter than group B (224.2 min) (p < 0.002), with more peri-operative complications occurring in group B and greater analgesic requirements. An open inguinal hernia repair under local infiltration block is the optimal approach for unilateral non-recurrent herniae as a day surgical procedure. These results have important cost and efficiency implications.
Anaesthesia 1995 Jul
PMID:Peri-operative outcome for day-case laparoscopic and open inguinal hernia repair. 877 94

Traditional surgical techniques base themselves on some conceptual mistakes, the first of which is that the new wall is built with lots of stitches and this is the reason for pain and long time spent in bed. The second one is that the new wall is built with the patient's muscles and aponeurotic tissues, this procedure leading to biological weakness. It is not possible to demonstrate the connection between traditional techniques and hernia recurrence, but we think that there are enough reasons to choose prosthesis technique. In all our cases of inguinal and femoral hernia the procedure applied was the Trabucco tension-free hernioplasty repair. This technique is simple, effective, rapid, the post-operative pain is reduced and all patients return to full activities rapidly. Now, with the modern prosthetic materials and new surgical techniques it's possible to repair all types of hernias and re-create normal anatomic function of the abdominal wall without new tension between muscles and aponeurothic structures. Authors show the actual trend of tension-free inguinal and femoral hernia repair, by taking into consideration risks, type of anaesthesia and surgical technique.
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PMID:Trabucco's procedure and local anaesthesia in surgical treatment of inguinal and femoral hernia. 765 86

Historical developments of groin herniorrhaphy date from Bassini's contributions through many present-day simplified tension-free techniques. Availability of sterile-packaged prosthetic mesh has currently given every surgeon an inexhaustible "tissue bank" for hernia repair surgery. The value of using a local anesthetic is unequaled in verifying the completeness of a repair. Same-day surgery has many advantages including lowered rates of infection, quicker ambulation, and more rapid return to regular activities. The sutureless umbrella plug technique is discussed. It is the simplest technique to permanently repair indirect inguinal hernias. Taking advantage of Nature' window through the internal inguinal ring, the properitoneal space can be reached. By dissecting the peritoneal sac high on its neck and shoulders, the retromuscular properitoneal space can be actualized. It allows a permanent repair to be done by simply protecting the internal ring with a swatch of polypropylene mesh shaped as an umbrella. The body's natural forces that created the hernia work to repair it by transversalis fascia. The procedure is easy to perform, done with local anesthesia, inexpensive, safe, and has minimal recurrence and complication rates.
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PMID:Day surgery for inguinal hernia. 765 89

Two of the most important etiological factors in the development of primary and recurrent inguinal hernias are collagen deficiency and tension on the suture line respectively. These factors can be eliminated by the use of open "tension-free" hernioplasty, advocated by the Lichtenstein Hernia Institute since 1984. In this procedure, the entire floor of the inguinal canal is reinforced by an 8 cm x 16 cm sheet of Marlex mesh that is sutured in place to protect the floor from all future adverse mechanical and metabolic effects without the risk of displacement or folding. A new ring and shutter mechanism is also created by the procedure, which is performed under local anesthesia and requires only a few hours of in-hospital postoperative observation. Pain control following the operation involves only 2-20 tablets of 5 mg hydrocodone bitartrate, for 2-4 days. The recurrence rate of early procedures was a mere 0.1%, and has been zero for 2,500 patients treated in the past five years. In addition, there has only been one complication (a testicular atrophy) in 4,000 operations over ten years. The postoperative pain and recovery period of the "tension free" procedure compare favorably with those of laparoscopic repair, while the complication and recurrence rate and costs are significantly lower. The Lichtenstein "tension-free" method has been performed on tens of thousands of patients worldwide and these results have been duplicated and published by authors from the United States, England, Belgium, Spain, Italy and Austria.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:An analytic comparison of laparoscopic hernia repair with open "tension-free" hernioplasty. 765 3

Lichtenstein's technique for surgical cure of primary inguinal hernia using local anaesthesia is described. Since 1984, 3250 primary hernia operations were performed at the Lichtenstein Hernia Institute. There were 4 recurrences due to technical errors which are described. This tension-free technique is a reliable, simple and effective procedure. Patients return to normal activity within 2 to 14 days. Studies one 22300 operations performed by several surgeons produced similar results for post-operative recurrence and complications.
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PMID:[Lichtenstein's "tension-free" operation for inguinal hernia under local anesthesia]. 775 42


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