Canalis Inguinalis Aperta– Treatment with Prosthesis Canalis Inguinalis Aperta– Treatment with Prosthesis

Abstract

Introduction: Canalis Inguinalis aperta presents a unique challenge in contemporary traumatology, particularly when it comes to surgical management in athletes. This paper aims to present the contemporary surgical approach for treating Canalis Inguinalis aperta in athletes, comparing the use of prostheses with other available methods.

Materials and Methods: A three-year retrospective study was conducted, including a total of 28 male patients aged 18-25 years, all of whom were treated surgically at Tetovo Clinical Hospital, Department of Surgery. The study focused on two groups: Group 1, consisting of 25 patients (89%), underwent hernioplasty with the implantation of a resorbable prosthesis using the tension-free technique. Group 2, comprising 3 patients (11%), was treated using the Lichtenstein technique with a non-resorbable polypropylene prosthesis.

Results: The average hospital stay was 1.5 days for Group 1 and 1.8 days for Group 2. The parameters analyzed included age, gender, hospitalization duration, recurrence rates, postoperative pain, complications, and rehabilitation for work and sports activities.

Discussion: The study highlighted that the group treated with resorbable prostheses showed superior outcomes in all analyzed parameters, including a lower recurrence rate and less postoperative pain. Additionally, the tension-free technique provided greater operational comfort for both the surgeon and the patient. In contrast, the group treated with the polypropylene prosthesis demonstrated slightly longer hospital stays and a higher incidence of recurrence.

Conclusion: The contemporary method of using a resorbable prosthesis for the treatment of Canalis Inguinalis aperta in athletes has shown clear superiority over the use of non-resorbable polypropylene prostheses, particularly in terms of preventing recurrence and providing operational comfort for both the surgeon and the patient. As a result, resorbable prostheses are increasingly preferred in the surgical treatment of Canalis Inguinalis aperta in athletes.

Keywords: Canalis Inguinal Aperta, Hernioplasty, Resorbable Prosthesis, Polypropylene, Athletes.

Introduction

We are witnessing the rapid development and evolution of all branches of medicine. In this context, surgery—specifically traumatology—has made notable progress in identifying the most effective methods and materials for treating various conditions. One of the ongoing challenges in practical traumatology is the surgical management of Canalis Inguinalis aperta in athletes. This challenge lies both in selecting the appropriate surgical technique and in choosing the materials used during the operation. The surgical management of Canalis Inguinalis aperta in athletes has seen significant advancements, both globally and locally, with a focus on the implantation of synthetic materials, commonly known as meshes. These meshes are typically composed of resorbable or non-resorbable materials. Recently, there has been significant competition among companies to offer the best surgical techniques and mesh materials for treating Canalis Inguinalis aperta in athletes. This paper aims to analyze and compare the use of resorbable and non-resorbable meshes in these cases.

Purpose of the Paper

The purpose of this paper is to present the contemporary surgical treatment method for Canalis Inguinalis aperta in athletes using prostheses, compared to other treatment methods, including classical approaches. Specifically, the study focuses on the comparison of resorbable versus non-resorbable polypropylene meshes.

Materials and Methods

This study is a retrospective analysis conducted over three years, involving 28 male patients aged 18–25 years, all of whom underwent surgical treatment at the Tetovo Clinical Hospital, Department of Surgery. The diagnosis of Canalis Inguinalis aperta in athletes was based on patient history (anamnesis), clinical examination, the appearance of soft tissue swelling in the inguinal region (provoked by coughing or post-exercise), and supporting laboratory and radiographic data.

Results

The average hospital stay was 1.5 days for Group 1 and 1.8 days for Group 2. The parameters analyzed included age, gender, hospitalization duration, recurrence rates, postoperative pain, complications, and rehabilitation for work and sports activities.

Discussion

The study highlighted that the group treated with resorbable prostheses showed superior outcomes in all analyzed parameters, including a lower recurrence rate and less postoperative pain. Additionally, the tension-free technique provided greater operational comfort for both the surgeon and the patient. In contrast, the group treated with the polypropylene prosthesis demonstrated slightly longer hospital stays and a higher incidence of recurrence.

Conclusion

The contemporary method of using a resorbable prosthesis for the treatment of Canalis Inguinalis aperta in athletes has shown clear superiority over the use of non-resorbable polypropylene prostheses, particularly in terms of preventing recurrence and providing operational comfort for both the surgeon and the patient. As a result, resorbable prostheses are increasingly preferred in the surgical treatment of Canalis Inguinalis aperta in athletes.

Keywords

Canalis Inguinal Aperta, Hernioplasty, Resorbable Prosthesis, Polypropylene, Athletes.

Introduction

We are witnessing the rapid development and evolution of all branches of medicine. In this context, surgery—specifically traumatology—has made notable progress in identifying the most effective methods and materials for treating various conditions. One of the ongoing challenges in practical traumatology is the surgical management of Canalis Inguinalis aperta in athletes. This challenge lies both in selecting the appropriate surgical technique and in choosing the materials used during the operation. The surgical management of Canalis Inguinalis aperta in athletes has seen significant advancements, both globally and locally, with a focus on the implantation of synthetic materials, commonly known as meshes. These meshes are typically composed of resorbable or non-resorbable materials. Recently, there has been significant competition among companies to offer the best surgical techniques and mesh materials for treating Canalis Inguinalis aperta in athletes. This paper aims to analyze and compare the use of resorbable and non-resorbable meshes in these cases.

EHO sonography [6,7]. During the surgical intervention, patients were given 2 g of third-generation Cephalosporin parenterally. The operation is performed with classic opening of the operative wound in the inguinal region and retraction of the anatomical layers of the abdominal wall. Opening of the aponeurosis of the m. Obliquus ext. abd., preparation of the funiculus spermaticus, opening of the m. cremaster, identification of the open canal and eventually if there is a sac, it is identified and reduced. The mesh is then placed. The resorbable prosthesis is placed over the open canal and eventually with two sutures with resorbable sutures in the tuberculum pubicum and in mm oblicus int. Abd. While in the polypropylene prosthesis, the fixation is done on the medial side on the suture in the pubic tubercle with the mesh, on the inferior side the mesh is fixed to the lig. Inguinal with continuous sutures then the mesh is fixed to the lower end of the m. Obliquus int. abd. And finally, the two ends of the mesh are fixed around the funiculus spermaticus so that one end is placed on top of the other [3,9]. The surgical wound is closed by suturing the anatomical layers of the abdominal wall. All patients were given GAET anesthesia.

Results

Two groups were formed, group I had 25 or 89%, who were treated with hernioplasty with the implantation of the resorbable prosthesis according to the tension-free operative technique, while group II had 3 or 11% patients, who were operated on with the polypropylene prosthesis method according to Lichtenstein.

The average hospital stays in group I was 1.5 days, while in group II it was 1.8 days. Postoperative complications were recorded in 2 or 7.15% of cases and manifested in the form of infection of the surgical wound, the appearance of seroma and hematoma. The applied method of anesthesia did not show a significant difference in the duration of hospital stay and the appearance of postoperative complications. There were no postoperative recurrences in the one-year period of our study. According to data in the literature, open inguinal canal surgery with prosthesis occurs in 1% of cases.

Discussion

The developments of modern surgical methods, techniques and operative materials have yielded good results in the treatment of open inguinal canal with prosthesis in athletes and have significantly improved the quality of life of patients, reduced the length of hospital stay, shortened medical leave, reduced the recurrence of the disease and accelerated the professional rehabilitation of patients. As a continuation of modern developments, today, for the solution of the problem of open inguinal canal with prosthesis in athletes, as a major problem, a new method of surgical treatment is preferred, which consists of a resorbable mesh, such as the mesh used in the Lichtenstein method.

Conclusion

We concluded that the contemporary method in the operative selection of Canalis Inguinalis aperta in athletes with resorptive prosthesis compared to the method with non-resorptive prosthesis (polypropylene) has evident superiority in all parameters analyzed in this study and in particular in the prevention of recurrence of the problem as well as in the operative comfort given to the surgeon and the patient. Resorbable prostheses are more preferred in the selection of Canalis Inguinalis aperta in athletes as an operative technique.

References