L Zogbi1. 1. Faculdade de Medicina (FAMED), Universidade Federal do Rio Grande (FURG), Campus da Saúde, Área Acadêmica. Rua Visconde de Paranaguá, 102, Secretaria Geral da FAMED, Zip Code 96203-900, Rio Grande, Brazil. zogbi@furg.br.
Abstract
BACKGROUND: The Lichtenstein technique is used worldwide because of its rapid learning curve, good results and low recurrence rates. In this approach, a lateral tie-shaped incision is made on the mesh, involving the spermatic funiculus and thus correcting the deep inguinal ring defect by narrowing it. The lateral tie, however, does not prevent the wrinkling of the upper portion of the mesh that is caused by the arched shape of the inguinal ligament, where the lower edge of the prosthesis is sutured. OBJECTIVE: To describe a variation of the Lichtenstein technique that is easy to perform, maintains the advantages and prevents wrinkling of the mesh and allows for better mesh accommodation in the inguinal region. METHODS: The main feature of this approach is to cut the mesh vertically and to make the tie over the spermatic cord by overlapping the two resulting portions without wrinkling them. The final appearance is clearly more anatomical, allowing the mesh to be perfectly adapted for each patient. RESULTS: We operated on consecutive patients using this approach for more than 5 years. There have been no recurrences or specific mesh complications during follow-up, and the surgical aspect of this technique was clearly more anatomical. CONCLUSIONS: This method appears to be easier to perform and the surgical aspects of the technique are more anatomical for the patient.
BACKGROUND: The Lichtenstein technique is used worldwide because of its rapid learning curve, good results and low recurrence rates. In this approach, a lateral tie-shaped incision is made on the mesh, involving the spermatic funiculus and thus correcting the deep inguinal ring defect by narrowing it. The lateral tie, however, does not prevent the wrinkling of the upper portion of the mesh that is caused by the arched shape of the inguinal ligament, where the lower edge of the prosthesis is sutured. OBJECTIVE: To describe a variation of the Lichtenstein technique that is easy to perform, maintains the advantages and prevents wrinkling of the mesh and allows for better mesh accommodation in the inguinal region. METHODS: The main feature of this approach is to cut the mesh vertically and to make the tie over the spermatic cord by overlapping the two resulting portions without wrinkling them. The final appearance is clearly more anatomical, allowing the mesh to be perfectly adapted for each patient. RESULTS: We operated on consecutive patients using this approach for more than 5 years. There have been no recurrences or specific mesh complications during follow-up, and the surgical aspect of this technique was clearly more anatomical. CONCLUSIONS: This method appears to be easier to perform and the surgical aspects of the technique are more anatomical for the patient.