[Multilayer deep hernioplasty by E. Shouldice method in inguinal hernias].

Area of Science:

• Surgical techniques
• Anatomy
• Histology

Background:

• Inguinal hernias are common surgical conditions.
• The transverse fascia's structural integrity is crucial for preventing hernias.
• Previous studies have indicated potential structural weaknesses in the transverse fascia of hernia patients.

Purpose of the Study:

• To investigate the histological structure of the transverse fascia in the ilioinguinal area.
• To compare the collagen and elastic fiber content in individuals with and without inguinal hernias.
• To evaluate the long-term efficacy and pathogenetic basis of multilayer deep hernioplasty after E. Shouldice.

Main Methods:

• Histological examination of the transverse fascia from 20 cadavers (hernia vs. non-hernia groups).
• Qualitative analysis of collagen and elastic fiber content.
• Retrospective analysis of surgical outcomes for 786 patients with inguinal hernias.
• Long-term follow-up of 281 patients treated with Shouldice hernioplasty.

Main Results:

• The transverse fascia in patients with inguinal hernias showed a 1.5-2 times lower content of collagen and elastic fibers compared to controls.
• Multilayer deep hernioplasty after E. Shouldice demonstrated high reliability in surgical treatment.
• The procedure was confirmed as pathogenetic for inguinal hernia repair.

Conclusions:

• Reduced collagen and elastic fibers in the transverse fascia are associated with inguinal hernias.
• The Shouldice multilayer deep hernioplasty is a pathogenetic and highly effective surgical method for inguinal hernia repair.
• This surgical approach offers reliable long-term outcomes for patients.