[Progress in the treatment of inguinal hernia].
The aim of surgical treatment of inguinal hernia is to a) reduce post-operative pain and discomfort to a minimum allowing patients to return to the activities as rapidly as possible, and b) hold the recurrence rate under 1%. The Shouldice technique remains the gold standard; its real recurrence rate is about 5%. Applying a mesh in the retroperitoneal space by laparoscopy is a good approach and can theoretically reach both aims. In current practice however, laparoscopy is not always favorable: general anesthesia is mandatory, technical pitfalls lead to morbidity and later to recurrences. Tension-free procedures would provide the best compromise for achieving the two advantages of: a) reducing pain, discomfort and recurrence risks by eliminating tension and, b) local and or loco-regional anesthesia.
Marre
P
P
Centre de Chirurgie Herniaire - Courbevoie.
Damas
J M
JM
Pélissier
E P
EP
D000203:Activities of Daily Living; D000768:Anesthesia, General; D000772:Anesthesia, Local; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control; D012008:Recurrence; D012187:Retroperitoneal Space; D013526:Surgical Mesh; D013514:Surgical Procedures, Operative / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome