Title: Stoppa’s open preperitonealprolene mesh hernioplasty: A critical analysis of operative outcome in bilateral inguinal hernias and its place in present era
Authors: Dr Priya Ahire, Dr Nihar Chandak, Dr Gautami Joshi, Dr Shriram Savant, Dr Yugal Pathrabe
Hernia (Latin, rupture; Greek, bud) defined as protrusion of aviscus through an opening in the wall of the cavity in which it is contained. The zone of weakness is the common feature possessed by all hernias by way of which structures can pass through the wall of the cavity which contains them. Out of all the potential hernial sites inguinal area is unequalled in its structural weakness. In addition, due to the upright position acquired by man in course of evolution, the inguinal region is subjected to a large part of the weight of mobile intestines, which contributes towards the high incidence of herniation in human beings.
Hernias has been known since evolution of man and the history of hernia is the history of surgery as stated by Jose Felix. Many great men have been devising innovative methods to repair hernia surgically. First were the anatomical repairs amongst which bassini’s and shouldice’s repairs were accepted and followed worldwide. Later the use of prosthesis came into practice. As early as 1900, Phelps, Goepel and Witzel used silver wire braided meshes (known as silver filigrees) [4-7]. These early meshes were far from ideal. During the Second World Warcame the age of the plastics industry. These were polypropylene, polyester and expanded polytetrafluoroethylene (ePTFE), which paved the way for the prosthetic meshes available today[8-10]. This drastically decreased the rate of recurrences. With the acceptance of mesh usage, many pioneer surgeons came up with indigenous methods of using it. Then came the question of which plane the mesh is to be placed.