[Nylon-Darn herniorrhaphy: the method of choice in treatment of primary inguinal hernia].

INTRODUCTION: Nylon-Darn herniorrhaphy is a classic, open technique, simple to perform with a low recurrence rate. It is a "tension-free" method of herniorrhaphy. The aim of study was to analyze the results of Nylon-Darn herniorrhaphy at our clinic and point out advantages and disadvantages of the technique. MATERIAL AND METHODS: This study, dating back to May 1999 and up to May 2005, included 116 patients who underwent Nylon-Darn herniorrhaphy for primary inguinal hernia. Patients were operated at the Clinic for Abdominal and Endocrine Surgery, Institute of Surgery, Clinical center Novi Sad and if without complications, left on the first postoperative day. Two patients had cholelithiasis and laparoscopic cholecystectomy was performed simultaneusly. Intra- and postoperative complications were analyzed. RESULTS: The overall complication rate in our study was 22.4%. There was no perioperative mortality and intraoperative complications. The mean age of 112 males and 4 females was 51 years. An average duration of the operative procedure was 49.2 min, and the patients left hospital after 2.17 days. General endotracheal anestesia was performed in 69 cases and spinal in 47. CONCLUSION: Based on the results of Nylon-Darn herniorrhaphy in our study and on the results in the literature, this technique could be the method of choice for primary inguinal hernia repair. It is suitable for registrars and young surgeons working in clinics not specialized in this pathology.

Harmonic Scalpel hemorrhoidectomy: a painless procedure?

Since the surgical treatment of hemorrhoidal disease has been characterized by intense postoperative pain, recent studies have tried to modify the standard Milligan-Morgans technique. The up-to-date literature, in the experience of authors, has confirmed that the new method of Harmonic Scalpel hemorrhoidectomy reduces postoperative pain. The aim of our study was to statistically evaluate, based on our experience, the efficacy of this surgical approach in terms of reducing postoperative pain and establishing a stable hemostasis. Seventy-seven (77) patients suffering from hemorrhoidal disease, stage III and IV, underwent surgery in our clinic during the last five years. The postoperative pain was determined using the visual analog scale on the 1st, 2nd and 7th postoperative days. Patients were divided into two groups in regard to the surgical procedure applied. The data were statistically processed using the Statistica 7.0 software. We concluded that Harmonic Scalpel hemorrhoidectomy, due to less thermal damage, statistically significantly reduced postoperative pain with better hemostasis, compared with Milligan-Morgan's method of treating hemorrhoidal disease.