Load on the inguinal region under standard conditions in pigs.
OBJECTIVE
To find out the effect of standardised stress on the load of the inguinal region.


METHODS
Experimental study.


METHODS
Surgical university clinic, Germany.


METHODS
15 uncastrated adult male pigs.


METHODS
The tension force between the lateral edge of the rectus sheath and the base of the inguinal ligament was measured after simulation of the Shouldice repair. Standard stresses (coughing, straightening up into the upright position, small or large pneumoperitoneum, and electrical stimulation of abdominal muscles) were imposed.


METHODS
Intra-abdominal pressure and tension force in the inguinal region.


RESULTS
We found the highest (mean, SEM) intra-abdominal pressure during coughing (33.1, 5.2 mm Hg) with an increase in inguinal tension force of 4.1, 0.5 N. The upright position (20, 0.7 mm Hg) and the large pneumoperitoneum (25 mm Hg) produced similar values (4.7, 0.8 N and 3.7, 0.4 N, respectively), whereas the small pneumoperitoneum (10 mm Hg) and the electrical stimulation of muscles of the abdominal wall (4.4, 0.1 mm Hg) resulted in distinctly smaller changes (1.1, 0.2 N and 0.7, 0.1 N, respectively).


CONCLUSIONS
The amount of tension on the simulated Shouldice repair depended largely on the increase in intra-abdominal pressure. Compared with the force required to disrupt the normal inguinal canal (68.6 N) the inguinal load seems to be negligibly low. This finding strengthens the modern recommendation to allow only a short convalescence after Shouldice hernia repair.
Peiper
C
C
Surgical University Clinic, Rhenish Westfalian Technical University Aachen, Germany.
Junge
K
K
Bühner
A
A
Bassalay
P
P
Schumpelick
V
V
D000714:Anastomosis, Surgical; D000818:Animals; D003371:Cough / Q000503:physiopathology; D004548:Elasticity; D006552:Hernia, Inguinal / Q000601:surgery*; D008297:Male; D011028:Pneumoperitoneum, Artificial; D011312:Pressure; D013552:Swine; D013718:Tensile Strength