الفهرس Only 14 pages are availabe for public view
 |  | from | 142 |  |  |
| | | from | 142 | | |
Abstract
Inguinal hernia repair is the most frequently performed operation in general surgery. There has been a great upsurge in interest in hernias over at least 15 - 20 years sparked by the introduction and wide spread use of prosthetic mesh. In this study we evaluate the inguinal hernia repair by use lateral preperitoneal approach of Nyhus and Stoppa’s technique with placement of 12 x 10 em M-shape polypropylen mesh. This study included fifty patients admitted to Zagazig University hospital, department of surgery and general Zagazig hospital, complaining of inguinoscrotal hernia, the patients were examined properly and systematically. Some investigations were done such as kideney function testes, liver function testes, fasting blood sugar, plain x-ray chest, abdominal ultra sonography and I.V.U in suspected cases. The patients were subjected to M-shaped preperitoneal hernioplasty using Nyhus and stoppa’s technique. The patients were followed up for at least 1 year and clinically examined monthly at 1-12 months to determine early and later postoperative complication including ecchymosis, hamatoma, wound infection and recurrence. In our evaluation we can say that M-shaped preperitoneal hernioplasty (M.P.H) was indicated in all types of inguinoscrotal hemiaeither primary type or recurrent ormultirecurrent also M.P .H. was indicated in femoral hernia. We believe that M-shaped preperitoneal hernioplasty (M.P.H) provides important saving in surgical material costs when compared with other classical and preperitoneal procedures. In our openion at least 50% decrease in suture costs with respect to the Lichtenstien operation can be accomplished because only one no. 1 polypropylene suture is used for the whole M-shaped preperitoneal hernioplasty. M-shaped preperitoneal hernioplasty is a single safe and easy repair for inguinoscrotal hernias regard less of the type of hernia . or the concomitant clinicopathological feafures of the patient.The preperitoneal approach affords direct observation of the entire groin area making all defects readily identifiable. M-shaped preperitoneal hernioplasty is a safe and easy repair for all inguinoscrotal hernias and mostly for recurrent and although carfule follow up is mandatory to assess for late recurrence. Based on the aforementioned data, analysis of the five ”relevant end points” proposed for assessing new techniques and surgical outcomes after herniorrhaphy (technical difficulty, overall complication rate,• overall rehabilitation, recurrence rate and socioeconomic factors), shows that MPH fulfils the essential requirements for a modem-day option for the treatment of groin hernias. Lastly we conclude that, since so far no special method for repairing inguinal hernia has been proved to be outstanding and the majority of hernia surgery will be performed by surgeons not highly specialized in hernia surgery, the best way to reduce the recurrence rate will be to improve the technical skill and the judgment of the surgeons, remembering that only patients can give us the clues for progressing toward a suitable hemioplasty.