| Autor: |
Christiano CLAUS, Leandro Totti CAVAZOLLA, Marcelo FURTADO, Flavio MALCHER, Edward FELIX |
| Jazyk: |
English<br />Portuguese |
| Předmět: |
|
| Zdroj: |
ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
| Druh dokumentu: |
article |
| ISSN: |
0102-6720 |
| DOI: |
10.1590/0102-672020210002e1597 |
| Popis: |
ABSTRACT Background: Since publication of our paper “Ten Golden Rules for a Safe MIS Inguinal Hernia Repair” we have received many questions. As the authors, we feel it is important to address these topics as a follow-up to our paper. Aim: To discuss in more details the main points of controversy, review the rules and update de recommendations. Method: The questions and discussions came mainly over five rules, numbered 3, 5, 6, 7, 10. We analyzed all the comments about recommendations and update some technical principles. Results: Rule 3 - Removing normal fat plugs from the obturator canal is unnecessary and therefore is not recommended; Rule 5 - transection of the uterine round ligament (1 cm proximal to the deep ring) facilitates adequate dissection. When performed in this way it does not appear to be associated with complications; Rule 6 - transection of huge sacs are safer than over-dissection of the cord structures. Whether dissecting completely the sac or abandon the distal part it results in less postoperative seromas is an ongoing debate; Rule 7 - any retroperitoneal structure traversing the internal ring is or play a role like a hernia. Failing to identify and remove the lipoma will ultimately result in the patient experiencing a recurrence; Rule 10 - in TAPP peritoneum should preferably be closed with suture than tackes. Conclusion: 10 Golden Rules emphasize the most important surgical tips and technical steps that allow the safe performance of MIS repairs of inguinal hernias, regardless the technique. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
|
