[Causes of complications and failures of hernia repair: how to avoid them].
Prevention of complications of inguinal hernia repair is first of all based on precisely dissecting the hernial sac and respecting the components of the spermatic cord and the blood vessels of the region. Resecting the sac is not necessary if it can easily be reintegrated into the abdominal cavity. Muscle reinforcement with synthetic mesh is the method that provides the most reliable repair. Systematic antibiotic therapy with prosthetic repair does not seem necessary if there is no risk factor for infection. During laparoscopy, the mesh must be a minimum of 10 x 15 cm; it is preferable not to attach it to prevent any nerve lesion. If necessary, fixation should be minimal and avoid nerve passage zones. During recurrence surgery, using an approach different from the preceding procedure is preferred so as to prevent dissection within the scar tissue.
Service de Chirurgie Digestive, Endocrinienne et Générale, CHU Dupuytren, 2 avenue Martin Luther King - Limoges cedex. gainant@unilim.fr
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Gainant
D059685:Herniorrhaphy; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D011183:Postoperative Complications / Q000517:prevention & control; D012008:Recurrence; D012086:Reoperation / Q000379:methods