Gilbert A I
Hernia Institute of Florida, Miami 33143, USA.
Int Surg. 1995 Jan-Mar;80(1):4-8.
Historical developments of groin herniorrhaphy date from Bassini's contributions through many present-day simplified tension-free techniques. Availability of sterile-packaged prosthetic mesh has currently given every surgeon an inexhaustible "tissue bank" for hernia repair surgery. The value of using a local anesthetic is unequaled in verifying the completeness of a repair. Same-day surgery has many advantages including lowered rates of infection, quicker ambulation, and more rapid return to regular activities. The sutureless umbrella plug technique is discussed. It is the simplest technique to permanently repair indirect inguinal hernias. Taking advantage of Nature' window through the internal inguinal ring, the properitoneal space can be reached. By dissecting the peritoneal sac high on its neck and shoulders, the retromuscular properitoneal space can be actualized. It allows a permanent repair to be done by simply protecting the internal ring with a swatch of polypropylene mesh shaped as an umbrella. The body's natural forces that created the hernia work to repair it by transversalis fascia. The procedure is easy to perform, done with local anesthesia, inexpensive, safe, and has minimal recurrence and complication rates.