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Minerva Chir ; 66(1): 21-40, 2011 Feb.
Artigo em Italiano | MEDLINE | ID: mdl-21389922

RESUMO

AIM: Can the tension-free suturless technique, used in the surgical treatment of inguinal hernia, to be the gold standard for treatment of inguinal hernia? METHODS: The tension-free suturless technique is often criticized as a fundamental principle: do not have suture. The criticism stems from concern that the mesh can migrate and cause damage to important anatomical structures. We conducted a study on the mobility of prosthesis on 33 patients, by using titanium clips that we have fixed on the meshes corner, X-rays over time, done at last, a follow-up of ten years. RESULTS: The study shows that the prosthesis moves together with the anatomical space in which there is the forces present in the inguinal canal: gravity, intra-abdominal pressure, reactive force ascending gait. Across thirty-three patients have relapsed in the first six months and two recurrences in ten years, in the reconstitution of the neo-orifice, through which passes the cord. In the remaining patients the mesh were relocated upward and medially (as identified by the clips of the increase of 10-15%). CONCLUSION: Our study shows that the mesh migrates upwards and medially. Migration is more or less, depending on the patient's age and quality of its tissue. Fix the prosthesis is good practice to secure at the flag on the inguinal ligament leads to two advantages: not to frustrate the principle tension-free, since the fixed prosthesis on one side does not create moments of tension, and prevent the prosthesis returns to the opening road to relapse.


Assuntos
Migração de Corpo Estranho/epidemiologia , Hérnia Inguinal/cirurgia , Implantação de Prótese/métodos , Telas Cirúrgicas/efeitos adversos , Técnicas de Sutura , Idoso , Procedimentos Cirúrgicos Ambulatórios/métodos , Fenômenos Biomecânicos , Feminino , Seguimentos , Migração de Corpo Estranho/prevenção & controle , Hérnia Inguinal/diagnóstico por imagem , Hérnia Inguinal/terapia , História do Século XVIII , História do Século XIX , História do Século XX , História Antiga , História Medieval , Humanos , Laparotomia/história , Masculino , Pessoa de Meia-Idade , Seleção de Pacientes , Radiografia , Recidiva , Funda para Hérnia/história
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