الفهرس يوجد فقط 14 صفحة متاحة للعرض العام
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المستخلص
Inguinal hernia repair is a very common performed general surgical operation. The surgical repair has been subjected to periods of stasis and explosive innovations. Most surgeons have spanned a period of tissue repair in its many forms, to the introduction and championing of prosthetic mesh. To keep tension at an absolute minimum, the floor of the canal is reinforced with a mesh. The mesh repair proved to have several disadvantages; its tendency to shrink (up to 30%), it may resist incorporation into body tissue, it performs badly when exposed to pathogens, it may migrate, may produce adhesions, and may erode into intraperitoneal organs. Such complications may become apparent years after the repair, presenting as an abscess, fistula, or small bowel obstruction. Furthermore, delayed complication may occur, of chronic mesh rejection up to 4 years after the operation, with or without groin sepsis. Most common and serious long term complication following inguinal hernia repair is chronic post operative pain (mesh inguinodynia). It’s an annoying outcome to the patient. It’s due to induced excessive fibrosis leading to entrapment of nerves due to the mesh surface area, and during fixation of the mesh and mesh induced scar plate formation. Neuroma formation occurs together with myelin degeneration. Ultimately neuropathy occurs. The weight of the applied mesh is another factor which will hopefully be resolved by the use of light meshes, which will make the already expensive mesh, even more unaffordable to all patients. Cost effectiveness is an important issue in developing countries, especially like ours.