[Changes in strategy and technics in the surgical treatment of hernias]

During last five years, 1,271 patients with the diagnosis of hernia were operated at the IIIrd Surgical clinic, 1st Faculty of Medicine, Charles University in Prague. Types of hernia were not differentiated. The patients group includes primary inguinal hernias and their relapses, hernias in other localizations as well as hernias in cicatrices. Ligation of the hernia sac as a separated intervention was used in no case. Herniorrhaphy was performed in 52% of cases, hernioplasty in 48%. The hernioplasty/herniorrhaphy ratio increases every year. While the hernioplasty was performed in 34% of patients in 1993, in 1997 was used already in 53% of cases. During that period of time, prolene mesh fixed in the defect with prolene suture was almost exclusively used as implant. In very complicated cases, Goretex was applied with a very good result. Polytetrafluoroethylene is the best implant material at the present time, but its price restrains its general use. Prolene is available for a moderate price and complies sufficiently with requirements on mechanical strength and non-irritability.