A Tension-free Herniorrhaphy Using the Prolene Hernia System: Clinical Experiences

PURPOSE: The aim of this study was to detail clinical experiences with a new type of tension-free herniorrhaphy using the Prolene Hernia System (PHS) and analyze the system' usefulness. METHODS: We reviewed 48 cases of herniorrhaphy using PHS and 45 cases of conventional herniorrhaphy retrospectively by reviewing the medical records of patients undergoing either procedure between January 2000 and February 2005. RESULTS: There was no significant difference in the operation time (P=0.054) or the length of hospital stay (P=0.138) between the groups. However, the need for analgesic therapy in the PHS group was less than in the control group (P= 0.008). There were no serious postoperative complications, but wound complications occurred more often in the PHS group (6 seromas and 2 hematomas), and urinary retention occurred more frequently in the control group. The recurrence rate in the control group was 2.2% (1/45), but there were no recurrences in the PHS group for 46 months. CONCLUSION: Herniorrhaphy using the PHS is safe and effective as conventional surgery. It can be carried out under local anesthesia more easily, and it is less painful than the conventional surgery. We suggest that the PHS be widely adopted as a method of tension-free herniorrhaphy.

Clinical Analysis of the Hemorrhoidectomy with Pure Local Anesthesia

PURPOSE: We hoped to evaluate the possibility of substitution of the local anesthesia for the spinal anesthesia in hemorrhoidectomy. METHODS: We did Milligan-Morgan hemorrhoidectomy under local anesthesia for the sixty- eight patients from January 1998 to December 2005. These patients were compared with seventy-nine patients of spinal anesthesia, sampled with similar gender, age, a surgeon, retrospectively. We used a mixture of 0.5% lidocaine and 1:200,000 epinephrine into perianal skin and intersphincteric space. RESULTS: The male-to-female ratio was 1:1 in local anesthesia group and 1:0.84 in spinal anesthesia group. The mean age was 50 and 46 respectively. The number of excised pile was 3.9 and 3.8 respectively. The frequency of the analgegics injected within first 24 hours was 1.79 and 2.70 respectively (P=0.001). The frequency of the urinary catheterization was 0.07 and 0.69 respectively (P < 0.001). The first bowel movement after surgery was 1.2 days and 1.6 days respectively. The hospital stay was 6.4 days and 8.1 days respectively (P=0.06). CONCLUISIONS: Local anesthesia is simple, safe and effective in the hemorrhoidectomy.