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Chirurgia 2000 June;13(3):135-40

language: Italian

Five years' experience with ''tension free'' hernioplasty

Ciaccia E., Piazza A., Antonello G., Franzato B., Balduino M., Dal Pozzo A., Otuoke S., Sartori C. A.


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Background. The aim of the present study is to analyze retrospectively the results of April 1994 to April 1999 experience regarding 2134 groin crural hernioplasties effected on 2083 patients.
Methods. 1756 operations were performed with the Lichtenstein technique, 224 with the Robbins-Rutkow technique, 1 with the Trabucco technique, 4 with the PHS net technique, according to Gilbert, 1 with the Stoppa technique. The total number of tension free operations was 1986, with the use of polypropylene meshes. The technique of Bassini and of Shouldice has been abandoned since 1994. The most recent physiopathologic characteristics which have led the choice particularly to the operation of Lichtenstein and, in selected cases, to the Robbins-Rutkow are defined. These operations can be performed under local anesthesia in ''one day surgery''.
Results. The recurrence rate observed was 0.5% it less than what has been reported in the past in non tension free techniques.
Conclusions. Tension free operations are sure, easily reproducible and can be adopted not only in all the anatomic varieties of hernia defect but also in recurrent bilateral groin hernias. Laparoscopic techniques show similar results, regarding complications and recurrences, but indications are more restricted because of the need for a surgeon who is expert in laparoscopic techniques.

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