Minimally invasive operation techniques for inguinal hernia: spectrum of indications in Austria |
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Authors: | M Scheyer S Arnold G Zimmermann |
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Institution: | (1) Hospital Bludenz, Department of Surgery, Krankenhaus der Stadt Bludenz, Spitalgasse 13, 6700 Bludenz, Austria,;(2) Country Hospital, Department of Surgery, 6800 Feldkirch, Caringasse, Austria, |
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Abstract: | At the beginning of the 1990s, the introduction of endoscopic surgery led to the surgical treatment of hernias being reconsidered.
At present, there are three groups of surgical procedures: conventional procedures (Shouldice, Bassini), open, tension-free
mesh procedures (Lichtenstein, Gilbert, Rutkow) and endoscopic procedures, predominantly transabdominal preperitoneal hernioplasty
(TAPP) and total extraperitoneal hernioplasty (TEP). The debate about the optimum treatment for hernias provoked by the endoscopic
procedures is understandable in view of the large number of hernia operations performed. Numerous studies, some randomised,
have demonstrated both advantages and disadvantages for the individual surgical procedures. In addition to the recurrence
and complication rates, the cost factor and socio-economic aspects of the operations are playing an increasingly important
role in deciding which method should be used. In December 1995, Austrian surgeons concerned with the problems of hernia repair
both before and since the introduction of laparoscopic hernia repair came together for a consensus conference. During the
meeting, the relevant aspects were summarised and a range of indications were established for surgical interventions. The
main recommendation was that conventional open surgery, which can be performed under local anaesthesia, is indicated in unilateral
uncomplicated primary hernias. Endoscopic hernioplasty is indicated if the contralateral findings are inconclusive or the
hernia is bilateral or recurrent. The Zürser Hernienforum (Zürs Hernia Forum) has now been founded. The function of this forum
is to carry out a prospective randomised study of inguinal hernia surgery throughout Austria.
Electronic Publication |
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Keywords: | Inguinal hernia operation procedures Bassini Shouldice Lichtenstein TAPP/TEP Zürs Hernia Forum |
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