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The Ugahary technique. Groin hernia repair with a large preperitoneal prosthesis via

Updated: Nov 15, 2022

Very symbolic photo: Franz Ugahary was particularly influenced by Georges Wantz on the left, and by René Stoppa on the right, for the development of his technique, our friend Eva Fischer, assistant to G. Wantz, is a follower of the technique at the Cornell Hospital in New York.

Your servant between René Stoppa and Franz Ugahary, or three generations of surgeons in search of a simple and effective treatment for groin hernias.

The technique presented here developed by Franz Ugahary and modified by me is the important step towards our MOPP technique (Minimal Open Pre Peritoneal).

This is the concept of minimally invasive surgery, performed through a single orifice in the groin. We still regularly use F. Ugahary's original technique for patients presenting with a recurrence after Shouldice or Lichtenstein, or after Plug placement, or after recurrence after any other classic anterior technique. Anesthesia can be local, currently readily general, "light", without intubation, with the use of a laryngeal mask, local anesthesia is associated for the immediate postoperative comfort of the patient. Day hospitalization is the rule, rapid return to normal activities are part of the technical environment. The 3 to 4 centimeter incision is located in the upper part of the inguinal region (above the bikini line).

the space between the peritoneum located behind, and the fascia transversalis and the muscles located in front, is cleaved. A large prosthesis is placed in this space. The muscles are suture with absorbable stitches, two subcutaneous stitches and adhesive strips (Stéri-strip) on the skin completing the closure.

This technique was very innovative in its minimally invasive nature. The total absence of fixation of the prosthesis and the almost exclusive use of cleavable spaces probably contribute to the low level of postoperative pain, favoring almost systematic ambulatory management. In addition, a rapid return to activities, a low rate of recurrence seems to contribute to a low overall cost of the technique. It represents for us the basis of the MOPP (Minimal Open Pre Peritoneal) technique, which I personally adapted according to the Ugahary surgical method, and which I currently practice preferentially.

I invite you to read the publication of the French Academy of Surgery which is the first presentation of the technique in France.

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