The Mitchell Banks Technique as the Standard Inguinal Herniorrhaphy : Clinical Experience With 8148 Cases and Changes in Operative Procedures

Abstract

Purpose : To evaluate the most standard inguinal herniorrhaphy based on the experience in a single institute. Methods : Inguinal herniorrhaphy in infants and children was carried out in 8148 patients at our department between May 1964 and December 1999. Results : Of these, 2600 cases were operated on by Ferguson's technique, 3865 cases by Lucas-Championniere's technique and 1671 cases by Mitchell Banks' technique, decade by decade. Twelve cases were operated on by other techniques. Recurrence occurred in 1 by Ferguson's, 5 by Lucas-Championniere's and 3 by Mitchell Banks' technique. Each recurrence rate was under 0.2%. There was no significant difference in recurrence rate among these procedures. The causes of recurrence were considered as the destruction of the neck of the sac while dissecting the hernia sac, or inadequate ligation of the neck. The necessary operating time for each procedure group was evaluated for a random sampling of 100 cases (50 males and 50 females) who were operated on by the author. Mean time was as follows : in Ferguson's group, 23.6 minutes in males and 16.4 minutes in females ; in Lucas-Championniere's group, 20.8 minutes in males and 14.5 minutes in females ; and in Mitchell Banks group, 11.5 minutes in males and 8.8 minutes in females. Conclusions : The Mitchell Banks technique is the simplest and safest procedure in which excision of the sac and high ligation are performed without opening the inguinal canal.