[Differentiated approach to preperitoneal alloplasty for complex recurrent inguinal hernias]

The results of surgical treatment of complex recurrent inguina hernias in 138 patients (all of them are men), ageing 30-82 yrs old, were analyzed. In 75 patients, suffering unilateral inguinal hernia and destroyed inguinal ligament, the preperitoneal alloplasty method, elaborated in the clinic, was applied, using operative access through inguinal channel with prolene mesh fixation to lacunar ligament. In 18 patients the mesh was sutured, using herniostapler with spiral-like fixation devices. In 47 patients the modified operation according to Stopa method was used for bilateral inguinal hernia recurrences, and in 16 patients--transabdominal preperitoneal laparoscopic hernioplasty for bilateral recurrences. The pain syndrome after the operation for unilateral recurrent inguinal hernia was observed in 5.9% patients, and for bilateral hernias - in 11.4% patients. The recurrences had occurred in 3.1% patients, suffering one-side inguinal hernia recurrence, and in 3.9% patients with bilateral recurrent inguinal hernias, in whom the net was sutured using prolene threads.