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Polypropylene mesh (Marlex) is well accepted for use in the peritoneum. Incisional hernias can be effectively repaired by anchoring Marlex intraperitoneally with a series of U sutures. These sutures pass through the normal body wall which remains after excision of the hernia sac and overlying attenuated fascia. When the sutures are taken up, an impenetrable diaphragm of Marlex is drawn into place beneath the abdominal wall defect. The defect itself is closed with other sutures. Only 2 of 25 patients had recurrences, and each recurrence came past the edge of the mesh. This operation is recommended for the repair of incisional hernias.

The Childs-Phillips plication operation was performed in forty-two patients, as treatment for recurrent small bowel obstruction in nineteen and as prophylaxis against future intestinal obstruction in twenty-three. Intestinal obstruction occurred later in only one patient. Eight of ten patients with acute peritonitis died in the postoperative period. Consequently, the operation is not recommended in the presence of generalized acute peritonitis.

The accuracy of operative cholangiograms can be increased by radiomanometry. This study identified 17 patients among 198 studied whose choledocholiths would have likely been missed by routine cholangiography. These are almost invariably small stones the fate of which would be conjectural if left behind. In the present study, if the cholangiogram was negative and the passage pressure within normal limits, calculi were seen only once. If the cholangiogram was positive for choledocholithiasis and the passage pressure elevated, stones were almost invariably found (95 per cent). Such accuracy cannot be expected from either roentgenography alone or determination solely of pressure relationships.