Views: 1,385 | Downloads:
220
| Responses: 0
| XML | Respond to this article | Alert & updates | Request permissions | Email to a friend |
Original ArticleOpen Access
The Usage of Two Umbrella Made-Mesh Plugs in Herniorrhaphy: Comparative Study with Bassini and Lichtenstein Method
Suradom C 
,
Palaphun J
,
Palaphun J Background: Operation to cure groin hernia remains a clinical problem. The most effective technique for hernia repairs isunknown and the presented recurrence rate varies between 1% and 10% at five years. Although surgeries with improvedtechniques with implanted materials are performed worldwide, they are limited because of the cost associated with herniarepair.
Objective: To determine the results of the presented two umbrella made-mesh plugs for inguinal hernia repair compared toother methods of herniorrhaphy.
Material and Method: The 194 patients, aged 16-86 years who had primary diagnosis of indirect inguinal hernia wereprospectively selected into two periods of elective surgery. The first period included, 58 cases operated with Bassini repair and11 cases needed relaxing incision, 42 in Bassini repair with umbrella made-mesh plug from polypropylene mesh and six casesthat needed relaxing incision. The second period included 40 cases of Lichtenstein repair, 54 cases using umbrella mademeshplug with patching tail. The outcomes for study were postoperative complications, hospital staying time, and recurrencerate of hernia within two years.
Results: All these patients had no mortality. Mean operative time was 31.8 minutes (25-50) of Bassini repair, 47.7 minutes(30-60) of Bassini repair with umbrella made-mesh plug, 53.2 minutes (38-60) of Lichtenstein repair, and 54.8 minutes (40-65)for usage of umbrella made-mesh plug with patching tail. Overall duration of hospital stay was one to seven days (mean3.5 days). Some complications were ecchymosis or seroma three in Bassini repair, three in Bassini repair with umbrellamade-mesh plug, and one in Lichtenstein repair. Wound infections were found with one case of Bassini repair and two ofBassini repair with umbrella made-mesh plug. Within two years of follow-up time, eight of 58 (13.8%) had recurrence byBassini repair while three of 42 (7.1%) in Bassini repair with umbrella made-mesh plug, but no recurrence in Lichtensteinrepair or umbrella made-mesh plug with patching tail.
Conclusion: The usage of both umbrella made-mesh plugs were safe for 94/96 cases of groin herniorrhaphy with only twoinfected meshes. The used mesh material (polypropylene) was easily made with an umbrella like shape during operation andlowered the cost. The mesh plug with patching tail had a suitable use for patching at wide hernia floor, so relaxing incisionswere unnecessarily done. For cases with small or no space of floor defect, repaired by mesh plug without patching may beadequate. Their two-year recurrence rates were lower than Bassini repair alone whereas the repair by using umbrellamade-mesh plug with patching tail and Lichtenstein repair had no recurrence. There was no difference in postoperativecomplications among all operations.
Keywords: Umbrella made-mesh plug, Herniorrhaphy, Complication, Recurrence
Objective: To determine the results of the presented two umbrella made-mesh plugs for inguinal hernia repair compared toother methods of herniorrhaphy.
Material and Method: The 194 patients, aged 16-86 years who had primary diagnosis of indirect inguinal hernia wereprospectively selected into two periods of elective surgery. The first period included, 58 cases operated with Bassini repair and11 cases needed relaxing incision, 42 in Bassini repair with umbrella made-mesh plug from polypropylene mesh and six casesthat needed relaxing incision. The second period included 40 cases of Lichtenstein repair, 54 cases using umbrella mademeshplug with patching tail. The outcomes for study were postoperative complications, hospital staying time, and recurrencerate of hernia within two years.
Results: All these patients had no mortality. Mean operative time was 31.8 minutes (25-50) of Bassini repair, 47.7 minutes(30-60) of Bassini repair with umbrella made-mesh plug, 53.2 minutes (38-60) of Lichtenstein repair, and 54.8 minutes (40-65)for usage of umbrella made-mesh plug with patching tail. Overall duration of hospital stay was one to seven days (mean3.5 days). Some complications were ecchymosis or seroma three in Bassini repair, three in Bassini repair with umbrellamade-mesh plug, and one in Lichtenstein repair. Wound infections were found with one case of Bassini repair and two ofBassini repair with umbrella made-mesh plug. Within two years of follow-up time, eight of 58 (13.8%) had recurrence byBassini repair while three of 42 (7.1%) in Bassini repair with umbrella made-mesh plug, but no recurrence in Lichtensteinrepair or umbrella made-mesh plug with patching tail.
Conclusion: The usage of both umbrella made-mesh plugs were safe for 94/96 cases of groin herniorrhaphy with only twoinfected meshes. The used mesh material (polypropylene) was easily made with an umbrella like shape during operation andlowered the cost. The mesh plug with patching tail had a suitable use for patching at wide hernia floor, so relaxing incisionswere unnecessarily done. For cases with small or no space of floor defect, repaired by mesh plug without patching may beadequate. Their two-year recurrence rates were lower than Bassini repair alone whereas the repair by using umbrellamade-mesh plug with patching tail and Lichtenstein repair had no recurrence. There was no difference in postoperativecomplications among all operations.
Keywords: Umbrella made-mesh plug, Herniorrhaphy, Complication, Recurrence
Download:
PDF