Inguinal hernia

Nyhus, Lloyd M.; Klein, Michael; Rogers, Frederick B.

doi:10.1016/0011-3840(91)90028-n

Cited by 89 publications

(46 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Giant meshes such as those advocated by Stoppa [2,5,7,8] benefit from tissue ingrowth as well as from the intraabdominal pressure which immobilizes them. Stoppa suggested that "the principle of the giant bilateral prosthesis (the immediate and definitive stability of the prosthesis owing to Pascal's hydrostatic principle) is different from those of all classical herniorrhaphies and hernioplasties using prosthetic patches (small meshes)" [6].…”

Section: Discussionmentioning

confidence: 99%

The influence of the number of endoclips and of mesh incorporation on the strength of an experimental hernia patch repair

Dion

Laplante

Charara³

et al. 1994

Surg Endosc

View full text Add to dashboard Cite

The strength conferred to a mesh by fixing it with laparoscopic staples and the effects of tissue incorporation have never been quantified. Eighteen dogs were divided into three groups sacrificed at 2 days (5 dogs), 2 weeks (6 dogs), and 2 months (7 dogs). One 3.5- by 5-cm piece of abdominal wall was removed from each side through a median laparotomy, leaving the skin intact. A polypropylene mesh (5 by 7 cm) was fixed over one defect with four Endopath EMS staples (Ethicon Endo-surgery) and over the other with 16 EMS staples. At sacrifice, bursting strength (BS) was measured with an Instron tester and specimens were studied histologically. One-way analysis of variance and the Newmann-Keuls multiple-comparison test were used. BS tests showed that for each period studied, the strength of the repair performed with 16 staples was significantly higher than that obtained when four staples were applied. They also showed that tensile strength increased significantly in both groups as time elapsed. Light microscopy supported the conclusion that the initial strength of the repair was related to the number of clips and was significantly increased by cellular infiltration at 2 weeks and significantly more by collagen deposition at 2 months. At 2 months, BS was significantly higher in the 16-staples group, suggesting that initial fixation still plays a significant role.

show abstract

Section: Discussionmentioning

confidence: 99%

The influence of the number of endoclips and of mesh incorporation on the strength of an experimental hernia patch repair

Dion

Laplante

Charara³

et al. 1994

Surg Endosc

View full text Add to dashboard Cite

show abstract

“…6 The operation time was defined as the time from the first incision to the placement of the last suture. We collected information about multiple operative and postoperative complications.…”

Section: Methodsmentioning

confidence: 99%

Comparison of Bassini Repair and Mesh-Plug Repair for Primary Inguinal Hernia: A Retrospective Study

et al. 2001

View full text Add to dashboard Cite

The purpose of this study was to compare the mesh-plug repair with the Bassini repair for the treatment of primary unilateral inguinal hernias. Patients with primary unilateral inguinal hernias who underwent a Bassini repair (n = 118) between January 1992 and May 1996 and a mesh-plug repair (n = 113) between July 1996 and April 1998 were retrospectively reviewed. We recorded information regarding the types of hernia according to Nyhus classification, operation time, complications, postoperative recovery, and recurrence after surgery. The two groups were comparable regarding age, sex, side of hernia, types of hernia, and the follow-up interval. The operation time was 55 +/- 20min for Bassini repair and 54 +/- 18min for mesh-plug repair. There was no incidence of mesh infection in the mesh-plug repair cases. The amount of diclofenac sodium (suppository) was 307 +/- 222mg in the Bassini repair group and 132 +/- 182mg in the mesh-plug repair group (P < 0.0001). The length of hospital stay was 8.2 +/- 2.0 days in the Bassini repair group and 4.3 +/- 2.7 days in the mesh-plug repair group (P < 0.01). Nine patients (7.6%) in the Bassini repair group had recurrence, compared with one patient (0.9%) in the mesh-plug repair group. The recurrence-free survival in the mesh-plug repair group was significantly longer than that in the Bassini repair group (P = 0.03). In conclusion, patients with primary unilateral inguinal hernias who undergo a mesh-plug repair recover more rapidly and have less recurrence in comparison with those who undergo a Bassini repair.

show abstract

“…Rather the selection of the procedure to be performed will be tailored to the clinical findings, that is, a Nyhus type I or II hernia should not require the same inguinal floor reconstruction demanded by a type III (Table 6). 18 The procedure described in this article is envisioned for the simpler hernias.…”

Section: Discussionmentioning

confidence: 99%

A Laparoscopic Intraperitoneal Onlay Mesh Technique for the Repair of an Indirect Inguinal Hernia

Fitzgibbons¹,

Salerno²,

Filipi³

et al. 1994

Annals of Surgery

104

View full text Add to dashboard Cite

ObjectiveThis study was done (1) to determine whether congenital indirect inguinal hernias in male pigs could be repaired by placing a polypropylene mesh prosthesis over the defect intra-abdominally, (2) to measure the incidence of adhesions between intra-abdominal viscera and the prosthesis with and without the adhesion barrier oxidized regenerated cellulose, (3) to determine the incidence of other complications, and (4) to assess the effect on fertility. Summary Background DataSeveral techniques for laparoscopic inguinal herniorrhaphy are currently being evaluated to determine whether there are advantages over conventional inguinal herniorrhaphy. Perhaps the most controversial is the intraperitoneal onlay mesh procedure (IPOM). Its advantage is its simplicity (in that the repair is accomplished by placing a prosthesis over the hernia defect intraabdominally, avoiding a groin dissection). Its disadvantage is the potential for complications because the prosthesis is in contact with the intra-abdominal viscera. MethodsIn male pigs, polypropylene mesh alone or polypropylene mesh plus the adhesion barrier oxidized regenerated cellulose (composite prosthesis) was fixed to the peritoneum surrounding the hernia defect. In phase 1 (6-week follow-up), two groups of 13 pigs each underwent herniorrhaphy at laparotomy or laparoscopy. In phase 2 (7.1-month follow-up), 21 pigs underwent laparoscopic herniorrhaphy. ResultsAll IPOM herniorrhaphies were successful. The prostheses adhered most frequently to the bladder, followed by small bowel, peritoneum, and cord structures. Prosthetic erosion into these organs was not observed. Laparoscopically placed prostheses in phases 1 and 2 had significantly less surface covered by adhesions (13% ± 13% and 19% ± 27%, respectively) and a lower adhesion tenacity grade (1.5 ± 0.9 and 1.3 ± 1.1, respectively) than those placed at laparotomy (44% ± 27% and 2.5 ± 0.7, respectively; p < 0.01). In phase 1, a histologic evaluation of laparoscopically placed specimens demonstrated significantly thinner above-mesh fibrotic tissue compared with the prostheses implanted at laparotomy (p < 0.04). In either phase, the use of the adhesion barrier did not produce any histologic difference between the polypropylene alone and the composite prosthesis. Fertility studies were performed in phase 2 and showed no adverse effects caused by either prosthesis. 144

show abstract

Inguinal hernia

Cited by 89 publications

References 50 publications

The influence of the number of endoclips and of mesh incorporation on the strength of an experimental hernia patch repair

The influence of the number of endoclips and of mesh incorporation on the strength of an experimental hernia patch repair

Comparison of Bassini Repair and Mesh-Plug Repair for Primary Inguinal Hernia: A Retrospective Study

A Laparoscopic Intraperitoneal Onlay Mesh Technique for the Repair of an Indirect Inguinal Hernia

Contact Info

Product

Resources

About