Kugel procedure through the primary incision in treatment of recurrent inguinal hernia with chronic pain after anterior repair of transversalis fascia / 中华全科医师杂志

Clinical data of 67 patients with recurrent inguinal hernia and chronic pain after anterior repair of transversalis fascia who underwent Kugel procedure through the primary incision in Wenling First People′s Hospital between June 2015 and January 2019 were retrospectively reviewed. During the operation the surrounding scar tissue and previous mesh or plug were removed, the transversalis fascia was separated and the patch was placed to overlay myopectineal orifice. The mean operative time was 57 min (51-85 min).The peritoneum rupture occurred during the operation in 6 cases (8.9%), and seroma was developed in 5 patients(7.5%). After a mean 18 months of follow-up, no recurrence occurred in all patients. Three months after operation, the mild, moderate or severe pain in all 67 patients were all improved remarkably with a total pain relief rate of 92.5%. The results show that Kugel procedure through the primary incision is safe and effective in treatment of recurrent inguinal hernia with chronic pain after anterior repair of transversalis fascia.

To Evaluate the Efficacy of Bi Pedicled Strip of External Oblique Aponeurosis for Augmentation of Posterior Wall of Inguinal Canal in Inguinal Hernia Repair

Introduction: In Homo sapiens and other mammalianquadrupeds, there is an absence of posterior rectus sheathbelow the arcuate line and insubstantial transversalis fasciain groin. This anatomical arrangement presents no particularfunctional, anatomic difficulty for quadrupeds as their inguinalcanal is directed uphill during ambulation and therefore isnot subjected to significant gravitational stress. Aims andobjectives: To evaluate the efficacy of bipedicled strip ofexternal oblique aponeurosis for augmentation of posteriorwall of inguinal canal in inguinal hernia repair.Material and methods: This study was carried out onfifty consecutive patients of inguinal hernia admitted in theSurgery Department of Guru Nanak Dev Hospital attached toGovernment Medical College, Amritsar.Conclusion: The present study was an attempt to evaluatethe role of bipedicled strip of external oblique aponeurosis inaugmentation of posterior wall of inguinal canal in inguinalhernia repair. Our findings suggest that the bipedicledundetached strip of external oblique aponeurosis is as efficientas a synthetic mesh in inguinal hernia repair. This repair isalso economically more beneficial for poor patients whocannot afford to have mesh repair. Although the present studyis small and follow up period is short but we still recommendthis procedure as a good alternative to Modified Bassini’s,Shouldice repair and mesh based repairs

To Evaluate The Efficacy Of Bipedicled Strip Of External Oblique Aponeurosis For Augmentation Of Posterior Wall Of Inguinal Canal In Inguinal Hernia Repair.

In Homo sapiens and other mammalian quadrupeds, there is an absence of posterior rectus sheath below the arcuate line and insubstantial transversalis fascia in groin. This anatomical arrangement presents no particular functional, anatomic difficulty for quadrupeds as their inguinal canal is directed uphill during ambulation and therefore is not subjected to significant gravitational stress. Aims and objectives: To evaluate the efficacy of bipedicled strip of external oblique aponeurosis for augmentation of posterior wall of inguinal canal in inguinal hernia repair. Material and methods: This study was carried out on fifty consecutive patients of inguinal hernia admitted in the Surgery Department of Guru Nanak Dev Hospital attached to Government Medical College, Amritsar. Conclusion :The present study was an attempt to evaluate the role of bipedicled strip of external oblique aponeurosis in augmentation of posterior wall of inguinal canal in inguinal hernia repair. Our findings suggest that the bipedicled undetached strip of external oblique aponeurosis is as efficient as a synthetic mesh in inguinal hernia repair. This repair is also economically more beneficial for poor patients who cannot afford to have mesh repair. Although the present study is small and follow up period is short but we still recommend this procedure as a good alternative to Modified Bassini's, Shouldice repair and mesh based repairs.

Técnica de Mohan P: desarda en la Herniografía Inguinal de forma ambulatoria / Mohan P: desarda’s technique in ambulatory inguinal herniorraphy

Se describe en este trabajo nuestra experiencia con una técnica de reparación de la hernia inguinal, en la cual la pared posterior del canal inguinal se fortalece con una franja fija de la aponeurosis del músculo Oblicuo Externo para producir una pared posterior fuerte y fisiológicamente activa. Revisamos las historias clínicas de los primeros 250 pacientes operados por esta técnica, que incluyen los meses de septiembre del 2001 a diciembre del 2005, los cuales son seguidos por consulta externa en nuestro Centro. Todos los pacientes fueron operados de forma ambulatoria. La hernia inguinal derecha y la variedad indirecta fue la más frecuente, hubo dos pacientes que presentaron sepsis de la herida y un paciente tuvo una recidiva. El ahorro económico fue significativo. La técnica quirúrgica es fácil de realizar, no requiere prótesis y ofrece resultados equivalentes a las reportadas que utilizan malla.

The objective of this work is to show our experience with an inguinal hernia repair technique in which the posterior wall of the inguinal chanel is streighten by an strip of the External Oblique Aponeurosis to make a hard and physiological active posterior wall. We present a series of the first 250 patients who underwent surgery by this technique between September 2001 to December 2005, all of them were follow up in outpatient department in our hospital. All of them were operated on ambulatory regimen. The right indirect inguinal hernia was the most frecuent. Two patients showed wound infection and one had an early recurrence. This technique isn’t expensive. The technique presented is ease to do, and involves minimal dissection and surgical trauma. It doesn’t need prothesis and show the same results.