Philosophy
Hernia recurrence is no more a
problem; it can be solved with prosthesis. Prostheses are our problem. Pure
tissue repair this is our target. The quality of a hernia operation depends on
the surgical experience and
expertise, the technique used, and from the patient. Our basic principle
in hernia surgery is to modify the anatomy respecting the physiology. This never
happens when a mesh is used. With the Guarnieri ' s technique we use the mesh
only when necessary. This happens in few cases. Furthermore, we use absorbable
sutures so that patients do not have foreign bodies and the recurrence rate is
very low.
There are three main techniques for hernia
repair:
Pure
Tissue
*
can be performed under local
anesthesia (one or half day surgery)
*
requires surgical
experience
*
recurrence rate is higher
(depends on surgical experience)
*
physiology could be respected
in most cases (depends on surgical
experience)
*
costs are lower
* less surgical complications compared with laparoscopic techniques
Mesh
Repair
* can be performed under local anesthesia (one or half day surgery)
* requires less surgical experience
*
recurrence rate is
lower
*
physiology is not respected
because of the presence of prosthesis
*
costs are mild
* low surgical complications compared with laparoscopic
techniques
*
is mostly performed under
general anesthesia (difficult to perform in one day surgery)
* is based on extensive experience in hernia repairs
*
the
recurrence rate depends on experience (it has higher recurrence rates now)
* physiology is not completely respected because of the presence of a posterior prosthesis
* is more costly
*
is
more often associated with serious intra-operative complications than other
techniques (peritoneal access)
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