Biomaterial Database

Ambulatory outpatient hernia surgery. Including a new concept, introducing tension-free repair. 1986

I L Lichtenstein, and A G Shulman

In 1985, Medicare started an experimental study in California mandating "Same-day" herniorrhaphy for all patients unless serious medical contraindication existed. Blue Shield and Blue Cross are rapidly following suit. It is little wonder therefore that ambulatory outpatient surgi-centers are now including hernia repair in their armamentarium. Change in environmental milieu must not compromise the quality of the surgery and care of the patient. This paper reviews the author's experience with outpatient hernia surgery and introduces a new surgical concept, tension-free repair. Since the first true herniorrhaphy was performed by Bassini over 100 years ago, all modifications and surgical techniques have shared a common disadvantage-suture line tension. This is the prime etiologic factor behind hernia recurrence. By using modern mesh prosthetics, it is now possible to repair all hernias without distortion of normal anatomy and with no suture line tension. The technique is simple, rapid, less painful, and effective; allowing prompt resumption of unrestricted physical activity.

UI	MeSH Term	Description	Entries
D008722	Methods	A series of steps taken in order to conduct research.	Techniques,Methodological Studies,Methodological Study,Procedures,Studies, Methodological,Study, Methodological,Method,Procedure,Technique
D010353	Patient Education as Topic	The teaching or training of patients concerning their own health needs.	Education of Patients,Education, Patient,Patient Education
D011182	Postoperative Care	The period of care beginning when the patient is removed from surgery and aimed at meeting the patient's psychological and physical needs directly after surgery. (From Dictionary of Health Services Management, 2d ed)	Care, Postoperative,Postoperative Procedures,Procedures, Postoperative,Postoperative Procedure,Procedure, Postoperative
D011229	Preanesthetic Medication	Drugs administered before an anesthetic to decrease a patient's anxiety and control the effects of that anesthetic.	Medication, Preanesthetic,Medications, Preanesthetic,Preanesthetic Medications
D011300	Preoperative Care	Care given during the period prior to undergoing surgery when psychological and physical preparations are made according to the special needs of the individual patient. This period spans the time between admission to the hospital to the time the surgery begins. (From Dictionary of Health Services Management, 2d ed)	Care, Preoperative,Preoperative Procedure,Preoperative Procedures,Procedure, Preoperative,Procedures, Preoperative
D002140	California	State bounded on the east by Nevada and Arizona, on the south by Mexico and the Pacific Ocean on the south and west, and on the north by Oregon.
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000556	Ambulatory Surgical Procedures	Surgery performed on an outpatient basis. It may be hospital-based or performed in an office or surgicenter.	Ambulatory Surgery,Day Surgery,Office Surgery,Outpatient Surgery,Surgery, Office,Surgery, Outpatient,Ambulatory Surgical Procedure,Procedure, Ambulatory Surgical,Procedures, Ambulatory Surgical,Surgery, Ambulatory,Surgery, Day,Surgical Procedure, Ambulatory,Surgical Procedures, Ambulatory,Ambulatory Surgeries,Day Surgeries,Office Surgeries,Outpatient Surgeries,Surgeries, Ambulatory,Surgeries, Day,Surgeries, Office,Surgeries, Outpatient
D000779	Anesthetics, Local	Drugs that block nerve conduction when applied locally to nerve tissue in appropriate concentrations. They act on any part of the nervous system and on every type of nerve fiber. In contact with a nerve trunk, these anesthetics can cause both sensory and motor paralysis in the innervated area. Their action is completely reversible. (From Gilman AG, et. al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed) Nearly all local anesthetics act by reducing the tendency of voltage-dependent sodium channels to activate.	Anesthetics, Conduction-Blocking,Conduction-Blocking Anesthetics,Local Anesthetic,Anesthetics, Topical,Anesthetic, Local,Anesthetics, Conduction Blocking,Conduction Blocking Anesthetics,Local Anesthetics,Topical Anesthetics
D013526	Surgical Mesh	Any woven or knit material of open texture used in surgery for the repair, reconstruction, or substitution of tissue. The mesh is usually a synthetic fabric made of various polymers. It is occasionally made of metal.	Mesh, Surgical,Meshes, Surgical,Surgical Meshes