FRANK J Glassow

The basic principle of the Cooper ligament repair is the closure of the deficiency in the posterior inguinal wall effected by suturing the upper margin of the defect, represented by the aponeurosis of the transversus plus its investing fascia, downwards to its insertion on to Copper's ligament along the superior ramus of the pubis lateral to the pubic tubercle. Because of tension, a relaxing incision in the anterior rectus sheath is frequently necessary. The basic principle of the ...

Short-stay surgery for inguinal hernia repair using the Shouldice technique, with local anaesthesia in the great majority of cases, has achieved a recurrence rate of less than 1% in the repair of both primary and recurrent inguinal hernia. A personal series of 14 982 consecutive inguinal herniorrhaphies performed during a 21-year period with an overall recurrence rate of 0.6%, using the Shouldice technique exclusively, is documented and discussed in some detail. The results suggest that ...

A study of 384 consecutive femoral herniorrhaphies performed upon female patients admitted to Shouldice Hospital, Toronto, during a 19-year period was carried out. Its main purpose was to describe the techniques used and to evaluate the results obtained. A careful 10-year follow-up plan for all cases existed.Two hundred and ninety-three operations were performed for the repair of simple femoral hernia; 91 were performed for the repair of femoral hernia which had developed following an ...

This is a review of a large and long experience in one hospital with more than 100 000 elective inguinal hernia repairs using local anaesthesia and emphasising the advantages of this type of anaesthetic. Subsections deal briefly with facets of this experience such as age, preoperative assessment, skin incision, the cremaster muscle, the testis, bilateral hernias, hernias in women, short hospital stay, follow-up, return to work and recurrence rates. Considerable emphasis is given to the ...

Of 1,101 consecutive primary femoral hernia repairs performed at Shouldice Hospital, Toronto, during the twenty-five year period between January 1, 1945 and January 1, 1970, 687 were performed in men and 414 in women. There were 362 instances of ipsilateral primary inguinal hernia in men and only 48 in women, so that 325 primary femoral hernia repairs alone were performed in men and 366 in women.The association of primary inguinal and femoral hernia in men is discussed in detail with ...

Extensive study of possible causes of wound sepsis revealed that the two most common were virulent staphylococci in nasal carriers among operating room team personnel and airborne pathogens in the operating room. If a surgeon finds he has an epidemic of infections, he should first of all consider himself as a possible source. A special mask patterned after the oxygen mask used by airmen is useful if the surgeon is found to be a source of infection. Ultraviolet light was found of value ...

The significance of postoperative wound infection in simple inguinal herniorrhaphy was studied in a series of almost 26,000 simple inguinal herniorrhaphies. There was a recurrence rate of about 1% in uninfected cases and 4% in infected cases. The wound infection rate was 1.8%. Of about 2500 patients with recurrent inguinal hernia admitted to the Shouldice Hospital, Toronto, following an initial operation of elsewhere, about 4% gave a history of postoperative wound infection. ...

A series of 2,105 femoral hernia repairs performed in a 17 year period has been reviewed. Of these, 1,138 were primary and 967 were recurrent. In the majority of the primary repairs (730 in men and 408 in women), a low or subinguinal approach was used. There was often an ipsilateral inguinal hernia, particularly in men, that required a separate simultaneous routine repair. An overall recurrence rate of approximately 2 percent was achieved in the primary group. Of the recurrent repairs, ...

The importance of freeing an indirect inguinal hernial sac or a peritoneal protrusion at the internal ring is discussed and emphasized. The technic at the internal ring used at the Shouldice Clinic is described.The justification for this technic lies in the results obtained. An analysis of more than 32,000 inguinal herniorrhaphies performed in this hospital between 1945 and 1961 is given, including more than 2,600 recurrent inguinal herniorrhaphies and 2,200 sliding inguinal ...