Annals of the Royal College of Surgeons of England
-
Ann R Coll Surg Engl · Nov 2000
Clinical TrialEarly results of inguinal hernia repair by the 'mesh plug' technique--first 200 cases.
Inguinal hernia repair is the most common surgical procedure performed in the UK. Evidence from several earlier studies suggests that primary inguinal hernia repair has a high recurrence rate of 10-15%. The Royal College of Surgeons of England guidelines suggested the use of layered suture (Shouldice) or prosthetic (Lichtenstein) repair. Per-fix plugs have been used in the US for more than a decade with excellent results. This study was a series of 200 consecutive cases. The aim was to evaluate the mesh plug technique in the repair of all types of inguinal hernias and its results in one consultant practice within a district general hospital. ⋯ Mesh plug repair is associated with minimal postoperative pain, quick recovery and return to work. It is an ideal technique for day-case surgery. Although longer follow-up will be required to assess true recurrence rate, so far the recurrence rate at 0.5% is acceptable, particularly in the light of other published series.
-
Debate exists about the benefits of laparoscopic appendicectomy when compared to a conventional open procedure. The majority of appendices are removed by the open route in the UK. We report a series of 132 cases of suspected appendicitis managed laparoscopically: 112 (85%) of the patients had acute appendicitis, the remaining 20 (15%) had non-appendiceal pathology. ⋯ Negative appendicocecotomies are most common in women of fertile age and can be associated with significant morbidity; therefore, laparoscopy should be used to make the diagnosis and, if appendicitis is the cause, the appendix could safely be removed laparoscopically. However, the choice between open and laparoscopic procedure is a subjective decision for the patient and their surgeon. Laparoscopic appendicectomy cannot be regarded as the gold standard.