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Inguinal hernia: a patch covering only the myopectineal orifice is effective
E P Pélissier1, D Blum, P Marre
1Clinique Saint Vincent, 40 Chemin des Tilleroyes, 25000 Besançon, France.
Hernia : the Journal of Hernias and Abdominal Wall Surgery
|August 17, 2001
Summary
This study introduces a simplified inguinal hernia repair using a small mesh. The technique effectively covers the myopectineal orifice, reducing recurrence and complications.
Area of Science:
- General Surgery
- Hernia Repair
- Surgical Innovation
Background:
- Large preperitoneal meshes can complicate future urogenital or vascular procedures.
- Hernia recurrences are often linked to the myopectineal orifice area.
- The Rives procedure, while effective, is technically demanding.
Purpose of the Study:
- To simplify the Rives procedure for hernia repair.
- To evaluate the efficacy and safety of a simplified inguinal mesh placement technique.
- To minimize complications associated with large mesh coverage.
Main Methods:
- A small mesh (8-10 cm x 6-7 cm) was placed in the preperitoneal space via inguinal approach.
- Mesh fixation was minimal or absent, with simple fascia approximation.
- 161 hernias (Nyhus types III and IV) were repaired using this simplified technique.
Main Results:
- A low complication rate of 3.7% (6 benign cases) was observed.
- A single recurrence (0.7%) occurred, attributed to mesh misplacement.
- Median follow-up was 63 months, with minimal reported pain and no late complications.
Conclusions:
- A small mesh covering the myopectineal orifice via inguinal approach is effective for hernia repair.
- This simplified technique offers a low risk of complications and drawbacks.
- The method provides a safe and efficient alternative to more complex procedures.