SAB NewsA New Technique of Physiologically Dynamic Inguinal Hernia RepairPosted 6/18/2002 Science Advisory Board member, Dr. Mohan P. Desarda at the Poona Hospital and Research Centre, Pune (India) has developed a new technique of inguinal hernia repair in which the posterior wall of the inguinal canal is strengthened with an undetached strip of the external oblique aponeurosis to give physiologically dynamic and strong posterior wall in all types of inguinal hernias is described. After excision of the sac, a strip of the external oblique aponeurosis (EOA) is partially separated from its medial leaf, keeping its continuity intact at either end. This undetached strip of EOA is sutured to the inguinal ligament below and the arch of muscle above, behind the cord, to form a new posterior wall. This strip is put under tension by muscular contraction and works as a shield to prevent recurrence. External oblique muscle gives additional strength to the weakened internal oblique and transverse abdominis muscles to keep this strip physiologically dynamic. A total of 400 patients have been operated on from 1983 to 1999 and follow up by physical examination was carried out. (One hundred and six patients have been followed up for more than 10 years.) The postoperative period was comfortable with a hospital stay of 1-2 days and a return to pre-operative work efficiency within 1–2 weeks. Recurrence was seen in only one case and haematocoele in one case. These results are comparable with operations performed with mesh. This operation is simple to perform, does not require mesh or dissection of the inguinal canal floor and has produced excellent results. Therefore it is a good alternative to mesh or other open or laparoscopic repairs. ### Reference articles: 1). ANZ Journal of Surgery, 2001,71(4):241-244 3). Eur J Surg 2001 Jun;167(6):443-8 |
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