Operative techniques

Today, the most used surgical techniques are those implying non absorbable prosthesis instead of sutures as done in the past.

These prostheses can be positioned through small abdominal incisions via laparotomy, by mostly using local anaesthesia (tension free and suture less repairs), as well as through a laparoscopic approach (by making three to four 5 mm holes in the abdominal wall) in general anaesthesia. As far as primitive (i.e. never operated) hernias are concerned, tension-free suture less techniques are to be preferred, all performed in local anaesthesia and in day-surgery regimen (patients can safely return home after surgery). This is the approach recommended in all the international guidelines. A laparoscopic approach, with some days hospitalization, has to be used in recurrences and in particularly complicated cases.

The technique used by us since 1991 for primitive groin hernias is the one adopting mesh. This mesh is make “ad hoc” for each patient: in other words is a “Tailored Surgery”, one surgery custom made, using different characteristics, weights and shape of meshes, for each single case. These meshes, thanks to special technique, don’t need suture.
Moreover we propose an approach, using a special fibrin glue, that guarantee a perfect adherence of the mesh, without the risk of damage the nerves, and the reduction of postoperative pain. The operation is with local anaesthesia and in day surgery with immediate patient discharge. The operation is simple and sure, (if properly performed). It lasted 60 minutes, but it stands to reason the surgeon must to be specialist.

Our experience, started in January 1992, is based on almost 3000 patients with a recurrence index < 1% and a complication index < 3%.Rete

During surgery the patient feels no pain (if the surgeon is expert) but only some pulling and pushing sensations. He may also listen to music, speak with the anaesthetist (constantly present) or any member of the surgical equip or simply rest.

When the operation is over, the patient has only a small band-aid on the inguinal region (no skin suture is foreseen). he can stand up, get dressed and go home. During post-operative period, the patient can return to a bland physical activity, eat, drink, walk and eventually take care of a sedentary job. Non - agonistic sports, may to start again after one week, and the professional athletes, in 10 days, can return at their competitions. At home he will have an informative brochure pertaining to all possible collateral effects that might rarely arise after the operation (pain, swelling, fever, nausea).

He can contact any member of the surgical equip 24 hours a day. A member of the above mentioned equip will phone the patient at home two times in the 24 hours following surgery. After one week the patient will be visited for a control.

Our experience from January 1992, is about 8000 operations, with a share of recurrences lower of 1% and a share of complication lower of 3%.