Inguinal Hernias in Elderly Patients. A New Method of Tension-Free Hernioplasty

Abstract

Aim of the study. To develop a new method of tension-free inguinal hernioplasty in elderly patients, which will expand the arsenal of effective open methods of surgical treatment of inguinal hernias and improve the results of their treatment. Material and methods. A total of 172 elderly patients with inguinal hernias were treated. Hernioplasty according to the Lichtenstein method was performed in 83 patients, and according to the developed method – in 89 patients. The testicular volume and blood flow in a.testicularis were determined by ultrasound before surgery, in the early postoperative period, and 1 year after surgery. Results. The developed method of hernioplasty has the following advantages: 1) it permits to reduce significantly the contact area of the elements of the spermatic cord with a mesh implant; 2) the back wall of the inguinal canal is strengthened not only by the mesh implant, but the aponeurosis of the oblique abdominal muscle; 3) a window in a mesh implant corresponds to the diameter of the elements of the spermatic cord, 4) no decrease in testicular volume at the site of the operative intervention is observed in the late postoperative period. Conclusion. The proposed method of hernioplasty is simple to use and surpasses the well-known Lichtenstein method in a number of parameters.

Impact of the type of anesthesia on the frequency of postoperative complications after hernioplasty and on the dynamics of the frailty index in elderly patients with inguinal hernia

“…This is due to the presence of age-related degenerative changes in the internal oblique and transverse abdominal muscles in the elderly, which leads to local complications (impaired fixation of the mesh endoprosthesis, flotation and folding of the prosthesis in the inguinal canal, and subsequently to a relapse of the disease. Only in clinics specializing in herniology, the recurrence rate did not exceed 2 % in strictly selected groups of patients [4,5].…”