ABSTRACT
OBJECTIVE: We report a prospective study of repairs using the Rives technique of the more difficult primary inguinal hernias, focusing on the immediate post-operative period, clinical recurrence, testicular atrophy, and chronic pain. A mesh placed in the preperitoneal space can reduce recurrences and chronic pain. METHODS: For the larger primary inguinal hernias (Types 3, 4, 6, and some 7), we favour preperitoneal placement of a mesh, covering the myopectineal orifice by means of a transinguinal (Rives technique) approach. The Rives technique was performed on 943 patients (1000 repairs), preferably under local anaesthesia plus sedation in ambulatory surgery. RESULTS: The mean operative time was 31.8 min. Pain assessment after 24 h with an Andersen scale and a categorical scale gave two patients with intense pain on the Andersen scale, and four patients who thought their state was bad. Surgical wound complications were below 1%, and urinary retention was 1.2% mostly associated with spinal anaesthesia and, in one case, bladder perforation. There was spermatic cord and testicular oedema with some degree of orchitis in 17 patients. The clinical follow-up of 849 repairs (86.4%), mean (range) 30.0 (12-192) months, gave five recurrences (0.6%), three cases (0.4%) of testicular atrophy, and 37 (4.3%) of post-operative chronic pain (8 patients with visual analogue scale of 3-10). CONCLUSIONS: The Rives technique requires a sound knowledge of inguinal preperitoneal space anatomy, but it is an excellent technique for the larger and difficult primary inguinal hernias, giving a low rate of recurrences and chronic pain.
Subject(s)
Edema/etiology , Hernia, Inguinal/surgery , Herniorrhaphy/adverse effects , Herniorrhaphy/methods , Orchitis/etiology , Testis/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Atrophy/etiology , Chronic Pain/etiology , Female , Herniorrhaphy/statistics & numerical data , Humans , Male , Middle Aged , Operative Time , Pain Measurement , Pain, Postoperative/etiology , Postoperative Complications , Prospective Studies , Recurrence , Surgical Mesh/adverse effects , Urinary Retention/etiology , Young AdultABSTRACT
No disponible
Subject(s)
Aged , Female , Humans , Adenocarcinoma, Mucinous/surgery , Peritoneal Neoplasms/surgery , Pseudomyxoma Peritonei/surgery , Teratoma/pathology , Ovarian Neoplasms/surgeryABSTRACT
No disponible
Subject(s)
Female , Humans , Middle Aged , Diverticulitis/diagnosis , Appendectomy , Appendicitis/pathology , Abdomen, Acute/etiology , Incidental Findings , Mucocele/diagnosis , Appendicitis , Diagnosis, DifferentialSubject(s)
Neoplasms, Multiple Primary/diagnosis , Ovarian Neoplasms/diagnosis , Peritoneal Neoplasms/diagnosis , Pseudomyxoma Peritonei/diagnosis , Teratoma/diagnosis , Aged , Female , Humans , Neoplasms, Multiple Primary/surgery , Ovarian Neoplasms/surgery , Peritoneal Neoplasms/surgery , Pseudomyxoma Peritonei/surgery , Teratoma/surgerySubject(s)
Breast Neoplasms/pathology , Carcinoma, Lobular/secondary , Sigmoid Neoplasms/secondary , Aged , Female , HumansABSTRACT
No disponible
Subject(s)
Humans , Female , Aged, 80 and over , Abdomen, Acute/etiology , Diverticulitis/complications , Intestinal Perforation/complications , Jejunum/injuries , Cholangiopancreatography, Endoscopic RetrogradeABSTRACT
No disponible
