THE TENSION FREE METHOD AT TREATMENT OF PRIMARY INGUINAL HERNIA USING POLIPROPILEN MESH BY ANTERIOR APPROACH

Abstract

The aim of this study is to evaluate the short and long term results of inguinal herni as in which hernioplosty was performed using polypropylene mesh by anterior approach. 752 hernia cases in 694patients were operated between May 1988 and June 1998 and followed until December 1998, were included in this study. in routine cases, drains were not used, But 28 hernia(% 3,7) when hemostasis was doubtful aspirative drains were used and these were removed on the first postoperative day. in all cases a single dose of 1 gr, IV Cefazolin has been given for prophylaxis. in 533 cases (76.8 %) geneli anesthesia, 64 cases (9.2 %) local anestesia and in 97 cases (l 4 %) spinal anesthesia were used. 594 of the cases (85.6%)were male and 100 of them(14.4%)were female. The youngest patient was 19 years old, the oldest was 83 years old and the average age was 39±6.3.The hernias of 482 patients(61.4%)were at the right side and the 207(26.3 %) were at the left and 97( 12,3 %) were found bilaterally, According to Nyhus classification, 201 cases (25.6 %) were classified as type II, 284(36,1 %) were classified as type IHA, 30H38.3 %) were classified as type IIIB. Alf patients were mobilized in the first 24 hours and except for 56 (7,7 %) where complications occured, patients were discharged on first postoperative day. The average postoperative follow-up was 66±29 month(minimum: 6 month-max: 127 month). During the early postoperative period, l6 cases (2. l %) had scrotal or subcutaneous hematoma, in 23 cases(3%) the oedema of injury or infection was formed. in 9 cases (l .2 %) recurrent hernia occurred at the operation site. There was no need to take out the mesh. We did not observe recurrent hernia in cases in which complication was occurred. As a result of our study, we found that the Lichtenstein method which has low rate of complication, low need of analgesia and easy to perform and low rate of recurrence and low cast can be safely used in primary inguinal hernia (Nyhustype II, IIIA, IIIB) in which the internal ring was enlarged or/and the continuation of the posterior wall was interrupted.