Inguinal herniorrhaphy with an undetached strip of external oblique aponeurosis: a new approach used in 400 patients.
OBJECTIVE
To describe my experience with a technique of 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 active and strong posterior wall.


METHODS
Retrospective open study.


METHODS
Medical college and district hospital, India.


METHODS
400 patients operated on 1983-99, 106 of whom have been followed up for more than 10 years.


METHODS
After the sac has been excised, a strip of external oblique aponeurosis is partly separated from its medial leaf, keeping its continuity intact at either end. This is sutured to the inguinal ligament below, and the arch of the muscle above, behind the cord, to form a new posterior wall.


METHODS
Morbidity and hospital stay.


RESULTS
No patient had severe pain postoperatively and nearly all patients (n = 396) were free of pain and discomfort after the second postoperative day. 340 patients (85%) were discharged by the 4th postoperative day, and most returned to normal activities within two weeks. There was one early haematocoele, and 1 recurrence at 2 years.


CONCLUSIONS
The operation is easy to do, does not require mesh, and gives results equivalent to those reported for mesh. It is therefore a good option for repair of an inguinal hernia.
Desarda
M P
MP
Bharati Vidyapith (Deemed University) Medical College, Pune, India. desarda@pn3.vsnl.net.in
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D013536:Suture Techniques; D013709:Tendon Transfer