| Interstitial recurrence, with chronic inguinodynia, after Lichtenstein herniorrhaphy. | |
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MedLine Citation:
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PMID: 14750000 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Not long after Lichtenstein and Shulman (1986) introduced their subaponeurotic repair, Nyhus (1989) expressed concern regarding subprosthetic incarceration. Even though interstitial recurrence was not encountered over the subsequent decade or more, one of us (AIG) was referred three cases over the past 3 years. Two men and a woman suffered from chronic inguinodynia 1-6 years following a Lichtenstein procedure for unilateral primary inguinal herniation. A mass, in an unusual location (spigelian line) was palpated in one, the other two required ultrasound studies for diagnosis. All at surgery revealed indirect sacs, and one also had a separate protrusion in the lateral triangle of the groin. Two were repaired laparoscopically, the other using a bilayer connected prosthetic device. Our hypothesis is that this painful complication is now appearing because of recent modifications to the operative technique. An overlay lax dome-shaped prosthesis cannot be relied on to always initially collapse the inguinal canal. Mini-dissection, by limiting exposure, may prevent placement of the keyhole in the mesh close enough to the internal inguinal ring. Studies are under way to determine the validity of these conclusions. |
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Authors:
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Raymond C Read; Arthur I Gilbert |
Publication Detail:
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Type: Case Reports; Journal Article Date: 2004-01-29 |
Journal Detail:
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Title: Hernia : the journal of hernias and abdominal wall surgery Volume: 8 ISSN: 1265-4906 ISO Abbreviation: Hernia Publication Date: 2004 Aug |
Date Detail:
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Created Date: 2004-08-04 Completed Date: 2004-12-01 Revised Date: 2005-08-30 |
Medline Journal Info:
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Nlm Unique ID: 9715168 Medline TA: Hernia Country: France |
Other Details:
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Languages: eng Pagination: 264-7 Citation Subset: IM |
Affiliation:
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University of Arkansas for Medical Sciences, Little Rock, Ark., USA. jrcrjr@erols.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Female Follow-Up Studies Hernia, Inguinal / diagnosis*, surgery* Humans Laparoscopy / adverse effects*, methods Male Middle Aged Pain, Postoperative / diagnosis, epidemiology* Postoperative Complications / diagnosis, surgery Recurrence Reoperation Risk Assessment Severity of Illness Index Surgical Mesh* |
| Comments/Corrections | |
Comment In:
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Hernia. 2005 May;9(2):201; author reply 202-3
[PMID:
15870957
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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