title: Internal ring occlusion and floor support: a novel technique for inguinal hernia mesh repair.
abstract: Tension-free, open-mesh, inguinal herniorrhaphies have gained wide acceptance. Current mesh techniques reinforcing the internal ring do not provide a comfortable lay to the mesh. To address this, we used the internal ring occlusion and floor support (IROFS) technique. A retrospective review was undertaken of all hernias operated on with the IROFS technique from January 2001 to December 2006. Five hundred twenty-five inguinal hernia repairs were done in 477 male patients. Telephone questionnaires looking into their postoperative course and recurrence were recorded. We contacted 275 (58%) patients. Patients' ages ranged from 29 to 81 years (mean, 57 years). The hernia was indirect in 50 per cent (n=146), direct in 35 per cent (n=102), or both in 15 per cent (n=44) of patients. The average operative time was 40 minutes. Acute wound pain lasted for less than 1 week in 55 per cent (n=151) and for 1 to 2 weeks in 24 per cent (n=66). Postoperative analgesic requirement was less than 1 week in 54 per cent (n=147) and 1 to 2 weeks in 27 per cent (n=74). Most patients returned to their daily activities in 2 weeks (75%) and to work in 3 weeks (74%). Chronic pain lasted for 6 to 48 months (mean, 20 months) in only seven patients. No recurrence of hernia was observed during follow-up visits (range, 26-96 months; mean, 53 months). In conclusion, IROFS can be performed with little difficulty, is cost-effective, and is well tolerated by the patient.
authors.affiliation: Department of Surgery, Providence Hospital and Medical Centers, Southfield, Michigan 48075, USA. drsgokul@yahoo.com
authors.forename: Gokulakkrishna
authors.initials: G
authors.lastname: Subhas
authors.forename: Daniel
authors.initials: D
authors.lastname: Bakston
authors.forename: Aditya
authors.initials: A
authors.lastname: Gupta
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Jacobs
authors.forename: Vijay K
authors.initials: VK
authors.lastname: Mittal
authors.forename: Sumet
authors.initials: S
authors.lastname: Silapaswan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology; D012189:Retrospective Studies; D013526:Surgical Mesh; D013514:Surgical Procedures, Operative / Q000379:methods*; D016896:Treatment Outcome