Controversy exists on the merits of the various approaches to inguinal repair. Evolution of the classic open repair has culminated in the Shouldice repair. Challenges from newcomers, namely, tension-free repair and laparoscopy, are being examined. These two techniques have a number of disadvantagesthe presence of foreign bodies (prostheses) and their implication in cases of infection; the cost of prosthetic material, which is no longer negligible (particularly with expanded polytetrafluoroethylene); and problems of safety in that the laparoscopic approach is no longer a dependable asset except in the hands of a highly specialized and dextrous operator. Still, complications occur with laparoscopic repair that should not be associated with a surgical procedure that is considered benign, safe and cost-effective. Surgeons must recognize the pertinent facts and decide according to their conscience which method of repair to use.

译文

关于腹股沟修补的各种方法的优缺点存在争议。经典的开放式维修的演变最终达到了Shouldice维修的最高水平。正在研究来自新移民的挑战,即无张力修复和腹腔镜检查。这两种技术有许多缺点,即异物(假体)的存在及其在感染病例中的影响。修复材料的成本不再可忽略不计(尤其是使用膨胀的聚四氟乙烯);以及安全性问题,因为只有在高度专业化和灵巧的操作员手中,腹腔镜检查方法才不再是可靠的资产。尽管如此,腹腔镜修复仍会发生并发症,这种并发症不应与被认为是良性,安全且具有成本效益的外科手术相关联。外科医生必须认识到相关事实,并根据自己的良心决定使用哪种修复方法。

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