Transcription
[Music] The biggest homework for early doctors in modern hernia surgery was recurrence. Recurrence was so common that there are records of recurrence rates reaching 100% within four years after surgery. Before the 1990s, autologous tissue surgery showed high recurrence rates ranging from 10% to 30%. >> Yes. Hospital Director, as seen in the video, recurrence was indeed a serious problem in the past. >> Yes, that's right. A recurrence rate of up to 30% means that one out of every five people experiences recurrence, so general surgeons who performed many hernia surgeries at the time were under a lot of stress due to this problem and conducted many studies to find its cause. The conclusion they reached was that it was due to tension. They agreed on this opinion, and tension means the force with which the sutured muscle tries to reopen, so after surgery, the muscle would reopen and tear again. Therefore, they thought it would eventually recur. >> Ah, so that's why the artificial mesh emerged as an alternative. >> Yes. You are exactly right. In 1987, a general surgeon named Lichtenstein in the United States announced tension-free surgery using an artificial mesh he developed. It was a method of covering the hernia defect with a snug artificial mesh without pulling the muscles. At the time, he announced that the recurrence rate for this surgical method was 0.7%, and with the added advantage of being relatively easy to learn, this surgical method spread rapidly worldwide. >> Yes. Through the Hospital Director's explanation, I easily understood the historical background of why the artificial mesh emerged. Now, let's address some points that viewers are likely most curious about regarding this topic through a Q&A. I will ask the first question. Why was the recurrence rate so high in past hernia surgeries? >> Yes. I mentioned earlier that past hernia surgeries had very high recurrence rates, reaching 10% to 30%. At the time, doctors believed that the cause of these high recurrence rates was the tension created during surgery. Tension means the force with which the muscle, pulled and stretched, tries to reopen. They judged that the recurrence was high because the muscle would reopen and tear again due to this force. However, it is more accurate to think that the recurrence was high not because of tension, but because the surrounding muscles were already damaged by the hernia, and the surgery was performed using those damaged muscles as they were. >> Yes. Second question. Why is artificial mesh surgery called tension-free surgery? During the time when the recurrence rate of past hernia surgeries was very high, doctors concluded that it was due to the tension created by pulling and suturing the muscles. Therefore, they developed a surgical method that did not involve suturing the muscles, meaning they left the defect as it was and covered it with an artificial mesh. Therefore, to emphasize the very low recurrence rate of artificial mesh hernia surgery, the term "tension-free surgery" is specifically emphasized. >> Yes. Then, let's move on to the third question. Dr. Lichtenstein reported a very low recurrence rate, but is the recurrence rate of artificial mesh hernia surgery actually that low? >> Dr. Lichtenstein reported a recurrence rate of 0.7%, but the recurrence rates of artificial mesh hernia surgery reported thereafter are usually 2% to 3%. However, it is more accurate to consider the recurrence rate observed in clinical practice to be around 5% to 10%. >> Yes. Then, this is the last question. This surgery was started to prevent recurrence, but why are there so many problems with artificial mesh surgery these days? The reason why artificial mesh surgery spread so rapidly is that it significantly lowered the high recurrence rates of the past, and the surgical method is very simple. Therefore, this surgery spread very quickly. However, the problem is that by focusing so much on the recurrence rate, the review of whether this plastic mesh, once placed inside the body, would cause long-term sequelae was quite insufficient in the early stages. As time passed, various unexpected problems such as chronic pain, infection, allergies, and foreign body sensation began to appear in patients who underwent artificial mesh hernia surgery. >> Yes. Ultimately, it was a method introduced to solve the major problem of recurrence, but we have come to realize that this choice was not the best for the patients. Next time, we will learn about the two methods of inserting artificial mesh: incision and laparoscopic surgery. >> At Gippeun Hospital, we have developed and are performing the Kangri-Pher hernia surgery, which does not use artificial mesh, to prevent artificial mesh sequelae. Our Kangri-Pher hernia surgery is a novel surgical method that has not existed before, with a current recurrence rate of 0.1% to 0.2% and a post-surgery discomfort rate of less than 0.5% after two years. Compared to artificial mesh hernia surgery, which reports a recurrence rate of at least 5% and a sequelae incidence of about 20%, our results are very superior. If you visit Gippeun Hospital, we will do our utmost to ensure that you achieve the best results with the new artificial mesh-free hernia surgical method that we have developed. [Music]