Inguinal hernias recurrence: causes and surgical treatment
Journal Title: Хірургія України - Year 2018, Vol 0, Issue 2
Abstract
The current paper reveals the definition and classification of recurrent inguinal hernia, the main causes of relapses are highlighted. According to modern data, the relapse causes are divided into three groups: factors caused by the general condition of the patient, morphological features of the primary hernia, and factors that depend on the attending physician. The dependence of the relapses occurrence on the technical errors of the surgeon has been analyzed. Particular attention is paid at the correctness of the certain hernioplasty technique implementation, the surgeon’s experience, the effective treatment method choice of the primary inguinal hernia. The attention is focused on the recurrence mechanisms after endoscopic methods for primary inguinal hernias, which have been increasingly used in general surgical practice. It presents the evolution of improvement laparoscopic plasty techniques to reduce the complications number and relapse rate: using a larger mesh, reducing the taker amount during fixation or the use of methods without fixation with fibrin glue, the entire mesh plastic without cutting it, which prevents relapses at the site of the mesh section. Approaches to the selection of a reliable hernioplasty technique for reducing the number of relapses have been presented. The data are based on the national Swedish and the Danish registers, recommendations of the EHS, according to which it is required to select an alternative mesh placement method to the previous alloplasty for the treatment of relapsing inguinal hernia, the latter allows to use less modified muscle‑aponeurotic structures in the treatment of recurrent inguinal hernias. In this case, special attention should be paid at the sufficient mesh overlapping of scar and atrophied tissues in the inguinal area. The matter of surgical treatment of recurrent inguinal hernias remains up‑to‑date and addresses further improvement.
Authors and Affiliations
Ya. P. Feleshtynskyi, A. А. Shtaier
Keywords
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- EP ID EP363434
- DOI 10.30978/SU20182102
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