O uso da prótese na correção das hérnias da parede abdominal é um avanço, mas o seu uso indiscriminado, um abuso


Autoria(s): Minossi, José Guilherme; Silva, Alcino Lázaro da; Spadella, César Tadeu
Contribuinte(s)

Universidade Estadual Paulista (UNESP)

Data(s)

20/05/2014

20/05/2014

01/12/2008

Resumo

The objective is to alert the surgeon about the indiscriminate use of synthetic prosthesis in the correction of inguinal and incisional hernias. The authors provide a brief history of surgery on hernias and a review of the literature, showing the importance of classifying inguinal hernias to fit the type of surgical correction with the defect found, abstaining from treating all hernias, with the same type of surgical procedure. In our opinion, small indirect inguinal hernias (type 1 and 2 of Gilbert) and hernias in women must not, in general, be treated with prostheses. The synthetic material should be reserved for direct and large indirect hernias. Even so, this attitude, besides determining a higher cost for the procedure, can lead to important complications such as infection, rejection, fistula formation, chronic pain, alterations in spermatogenesis and the possibility of carcinogenesis, according to more recent reports. The physiology and anatomy of the abdominal wall should be considered when dealing with incisional hernia corrections, where the surgeon can choose among many techniques to correct those defects, and in selected cases, utilize synthetic material. We conclude that although the use of biomaterials has constituted a great advance in surgery for abdominal wall hernia corrections because they decrease recurrences, and permit treatment of large abdominal hernias, the indiscriminate prosthesis usage is an abuse, and it can determine many serious complications, certainly avoidable with a well indicated non mesh technique .

Formato

416-424

Identificador

http://dx.doi.org/10.1590/S0100-69912008000600013

Revista do Colégio Brasileiro de Cirurgiões. Colégio Brasileiro de Cirurgiões, v. 35, n. 6, p. 416-424, 2008.

0100-6991

http://hdl.handle.net/11449/27842

10.1590/S0100-69912008000600013

S0100-69912008000600013

S0100-69912008000600013.pdf

Idioma(s)

por

Publicador

Colégio Brasileiro de Cirurgiões

Relação

Revista do Colégio Brasileiro de Cirurgiões

Direitos

openAccess

Palavras-Chave #Abdominal wall #Surgical mesh #Hernia #ventral #Prostheses and implants
Tipo

info:eu-repo/semantics/article