OC-007 RELIABLE AND COST-EFFECTIVE METHOD OF GROIN HERNIA SURGERY, BASED ON OPEN PRE-PERITONEAL APPROACH AND ORIGINAL MESH FIXATION

Abstract

Abstract Aim To analyze the results of original technique for groin hernia (GH) repair, via open preperitoneal approach (OPPA) had proposed by L.M.Nyhus. Material & Methods There were 161 patients 22–87 years old; in 25 cases GH were recurrent. After OPPA, the spermatic cord, inguinal ligament, interior inguinal ring and abdominal wall defect were always in full vision. GH sack was removed into abdominal cavity. The mesh, having spermatic cord got through a special orifice in it, was fixed to inguinal ligament along it full length, and to rectus abdominis muscle’ lateral edge. Inguinal abdominal wall defect was covered from within by mesh under visual and palpable control. Results Operation time takes 42.5±9.1 minutes for simple GH, and 103.5±21.4 minutes for irreducible inguinal-scrotal hernia. General burden of surgery was correspondent to minimal invasive. Follow-up to work became from 3–5th day. For 12 months 107 (60.9%) patients were followed, no hernia recurrence was found. Conclusions Our method has basic prevalence over: i) possibility of one-day surgery (longer hospitalization if comorbidities); ii) cost-saving because needn't in laparoscopic equipment; iii) simplicity and high reliability because of visual anatomic controlled mesh fixation and positioning for the total closing of groin gap. It may pretend for a proper approval at EHS guidelines. The learning curve and additional points, such as type and quantity of fixation points, best of mesh to be used, should be discussed after the further evaluation.