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Abstract. At the beginning of the 1990s, the introduction of endoscopic surgery led to the surgical treatment of hernias being reconsidered. At present, there are three groups of surgical procedures: conventional procedures (Shouldice, Bassini), open, tension-free mesh procedures (Lichtenstein, Gilbert, Rutkow) and endoscopic procedures, predominantly transabdominal preperitoneal hernioplasty (TAPP)...
Abstract. Fistulae due to polypropylene mesh are known to occur if the prosthetic mesh is placed close to a hollow viscus. Some cases of enterocutaneous fistula have been reported but there are few cases of fistula affecting the large bowel. It is important to recognize these cases because they are severe complications of the prosthesis and difficult to manage. We present a case of colocutaneous fistula...
Abstract. We present a case of a 78-year-old woman with abdominal-wall muscle paralysis following cutaneous herpes zoster in the T12-L1 dermatomes. An EMG confirmed paralysis, and a CT scan ruled out fascial defect. The paralysis had completely resolved 1year later. A review of the literature regarding these unusual sequelae of herpes zoster is presented.
Abstract. Parastomal hernia, particularly when recurrent, presents a troublesome problem to the surgeon. Since the late 1970s, prosthetic-mesh repairs have been used increasingly, though, as yet, there is no consensus on the best technique of repair. We report a case of failure of a polypropylene-mesh repair of a recurrent parastomal hernia, complicated by erosion of the mesh edge into the colon proximal...
Abstract. Laparoscopic treatment of inguinal hernias has expanded rapidly during the last decade. Several studies have evaluated the early results of this technique, and the rate of recurrence was estimated less than 5% with a range from 0.5% to 10%. The long-term recurrence after such treatment is still not well known. This study reports the 2year follow-up of laparoscopic treatment of 236 inguinal...
Abstract. Between 1990 and 1997, 284 patients were treated in our hospital for abdominal hernias. In the original group, 239 patients (84.15%) had midline hernia, and 45 (15.8%) had lateral hernia. A total of 152 midline hernia patients (63.5%) were treated using our variant of Rives technique. In all these cases, preperitoneal and retromuscular polypropylene mesh was used as a reinforcement and was...
Abstract. Two types of monofilament polypropylene meshes of markedly different construction, configuration and pore size were compared and used to repair full-thickness muscle defects in the abdominal wall of 22 mongrel dogs to assess their biocompatibility with host tissues. The defects were repaired with Prolene (Ethicon) woven mesh (pore size=16496m) and with an experimental, extruded mesh called...
Abstract. A large mesh in the preperitoneal space, spread on iliac vessels and bladder, can cause future difficulties in a case of urogenital or vascular disease. Since all recurrences are located in the area of the myopectineal orifice, a mesh covering only this area, as in the Rives procedure, is effective and avoids these drawbacks. However, the Rives procedure is demanding, which is why we tried...
Abstract. Spigelian hernia is considered a surgical rarity. Recent articles describe only six recurrent hernias and a scant number of patients with colonic obstruction resulting from incarceration. A patient with intestinal obstruction resulting from recurrent Spigelian hernia with strangulated colon is described. The patient underwent tension-free repair using a prosthetic mesh. Recent literature...
Abstract. We used monofilament polypropylene prostheses in 20 emergency operations for strangulated hernias. Sixteen of the operated patients had groin hernias (five of them recurrent), two had incisional and one had a Spigel's type hernia. Intestinal resection was performed because of bowel wall necrosis in one of the patients. During the postoperative period, we observed only one minor complication...
Abstract. A 44-year old, male, tattooed, leather jacket clad, Harley-Davidson motorcyclist arrived at the emergency room with a tender, irreducible mass, presenting at the external inguinal ring. In 1998, lung biopsy was read as miliary granuloma. No herniation was found on urgent preperitoneal exploration. Incision of the mass showed acid-fast bacilli. Culture later revealed Mycobacterium avium-intracellulare...
Abstract. To emphasize the importance of the experience of the operating team, we compared the two largest materials in the total extraperitoneal (TEP) and the transabdominal preperitoneal (TAPP) procedures in Poland. We performed 1225 procedures on 1110 patients (368 TEP and 809 TAPP). The experience of the operating teams measured by the mean number of procedures/surgeon was comparable. The mean...
Abstract.In a retrospective study, we examined 23 pre-term infants (18 boys, 5 girls) with a median weight of 1540g (range 7202770g) and a median age of 32weeks (range 2536weeks) gestation, who were subsequently operated on after a median of 65days (range 20121days) for 33 inguinal hernias. The infants were evaluated with respect to concomitant diseases as well as peri- and postoperative complications...
Abstract. The hypothesis that a hernia clinic could improve the results of external abdominal wall herniorrhaphy was tested in a teaching institution. From 1980 to 1988, all patients exhibiting external abdominal wall hernias were treated under protocol and separate from general surgical patients in a hernia clinic directed by a dedicated surgeon. The incidence of recurrence, infection, and testicular...
Abstract. The influence of mesh material on the clinical outcome of hernia repair has often been neglected, although recent studies have clearly demonstrated the importance of mesh properties for integration in the abdominal wall. Of particular significance are the amount of mesh material and the pore size. In the following study, patients received different mesh types with distinct amounts of polypropylene...
Abstract. The use of biomaterial meshes in the repair of incisional abdominal wall hernias is now widely accepted internationally. The introduction of synthetic meshes to achieve tension-free repair has led to a satisfactory reduction in the recurrence rate to less than 10%. However, the use of such biomaterials can result in the occurrence of undesirable complications such as increased risk of infection,...
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