Aspectos técnicos de la hernioplastia sin tensión en el tratamiento de la hernia inguinal

Introduction. The Lichtenstein procedure has become one of the most widely employed options for the treatment of inguinal hernia. Although the results are good, we sought to determine the influence of the type of suture and the mode of mesh placement on the outcome of the technique.
Patients and methods. The present prospective study focused on a series of 180 patients who were treated surgically for primary inguinal hernia by means of the Lichtenstein procedure with placement of polyproylene mesh. The patients were randomly divided into two groups, of 40 patients each, according to the suture thread employed (nonabsorbable or absorbable) and four groups of 20 patients each depending on the mode of mesh placement (running suture, interrupted suture, 4 to 5 stitches or no suture at all). The mesh was secured with 4 titanium staples at each vertex, and all the patients were examined physically and radiologically.
Results. There were no operative deaths. The overall morbidity rate was 8%, due to hematoma in 19 cases (7%) and seroma in 2 (0.7%). None of the patients developed infection involving the surgical wound or the mesh, and there were no cases of rejection. After one year of follow-up, there have been no cases of recurrence. There were no differences among the groups either in clinical or radiological terms.
Conclusions.. The Lichtenstein procedure is an effective repair technique regardless of the type of suture employed (absorbable or nonabsorbable) and the mode of mesh placement.