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[A surgical cure of inguinal hernias by the Shouldice procedure]
P Andronescu1, A Miron, C Andronescu
1Clinica de Chirurgie I, Spitalul Clinic U.M.F. Bucureşti.
Insights
The Shouldice procedure for inguinal hernia repair shows promising low recurrence rates. Further studies are needed, but initial results suggest it
Area of Science:
- Surgical Innovation
- Hernia Repair Techniques
Context:
- The Shouldice procedure is a recognized surgical technique for inguinal hernia repair.
- It is known for its low recurrence rates, with historical data showing less than 1%.
Purpose:
- To analyze the outcomes of the Shouldice procedure in a series of uncomplicated inguinal hernia cases.
- To evaluate the short-term and medium-term efficacy of the Shouldice technique in a specific surgical setting.
Summary:
- This study analyzed 73 cases of uncomplicated inguinal hernias repaired using the Shouldice procedure over three years.
- The technique involved cremaster resection and posterior wall reinforcement with nonresorbable sutures.
- While short-term follow-up showed good results in most patients, only 21 were reviewed at 6 and 12 months, with no reported recurrences within 3 years.
Impact:
- The Shouldice procedure demonstrates encouraging results for inguinal hernia treatment.
- These findings support its consideration as a primary surgical option, though more extensive data are required for definitive conclusions.
Abstract:
Shouldice procedure became an elective technique in inguinal hernia repair as a consequence of the spectacular results of the Shouldice Hospital in Toronto (less 1% recurrence rate) and of other surgical centres in USA or western Europe. In the present study 73 cases of uncomplicated inguinal hernias who underwent a Shouldice herniotomy are analysed within a period of three years. Cremaster resection was routinely performed preserving a one inch proximal fragment which was used to calibrate the inguinal ring after reconstruction. Two continuous nonresorbable stitches were used to reinforce the posterior wall, as described by the author. Short postoperative follow-up showed good results in 64 cases but only 21 patients were reviewed within 6 and 12 month. Nevertheless no recurrence was reported in 3 years by any patient. According to these encouraging results Shouldice procedure might be considered as the procedure of choice in the treatment of inguinal hernias but much more data are necessary for pertinent conclusions.