Sliding inguinal hernias.

PURPOSE To evaluate the frequency and anatomic presentation of sliding inguinal hernias as well as to analyze the technical difficulties during surgery and recurrence rate. METHODS During 18 months we have recorded in a prospective manner data on all patients operated in one hospital for non-complicated inguinal hernia. All patients suspected of sliding variant have had their hernia sac opened and the sliding organ identified. All repairs were done using tension free technique. One year after discharge a telephone interview was performed with all patients to verify if they are free of recurrence. RESULTS 464 patients were electively operated on for inguinal hernia during the study period. Sliding variant was diagnosed in 16 patients (3.4%). The sliding organs were: sigmoid colon in 10 patients (62.5%), urinary bladder in 2 patients (12.5%), appendix in 2 cases (12.5%) and caecum in 2 cases (12.5%). The tension free repair according to Lichtenstein or Rutkow-Robbins technique was performed in all cases. No major surgical complication was recorded. During 18 months follow-up we have seen one recurrence 3 months postoperatively. CONCLUSIONS The sliding inguinal hernia is a rare finding. The risk of injury of sliding organ is minimal. If tension free technique is used, the risk of recurrence is similar to that of patients with non-sliding inguinal hernia.