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Background/Aim. Despite a huge success in decrease rate of recurrences of inguinal hernia in mesh and "plug in" techniques, a new problem appears such as chronic pain and other complications. The aim of this paper was to present the original modification of bilayer patch device (Prolene Hernia System®, Ethicon) insertion in "non-plugged" fashion and 11-year experience with this open technique for the indirect hernia repair in a male. Methods. This retrospective study included 96 male patients with 103 indirect unilateral and bilateral inguinal hernias, operated due to a primary or recurrent hernia in an 11-year interval (2004-2015). In all operation an extended Prolene Hernia System® (PHS) bilayer patch device was inserted medially of inferior epigastric vessels through a small incision in Hasselbach's triangle, thus avoiding plug component of device connector into the internal ring. All data were taken from the medical records, operative protocols, and telephone questionnaire. Results. Non-plugged technique of bilayer patch device insertion was presented in details. Mean age of patients was 59 years. There were 3 (2.91%) patients with procedure-related complications, two patients with postoperative seroma and one with scrotal ecchymosis. There were 86 (89.6%) patients who answered on the questionnaire. During 11 years of following, recurrence of a hernia occurred in 1 patient, one had funiculocele and only one had chronic pain during 6 months. Almost all patients (97.68%) were satisfied with the procedure and results of hernia surgery. Conclusion. Nonplugged insertion of bilayer patch device is a safe technique for solving the primary and recurrent indirect inguinal hernias. The low incidence of the recurrence and chronic pain many years after the operation justifies this technique even in hospitals not specialized for the hernioplasty. [ABSTRACT FROM AUTHOR]

Background/Aim. After having established an indication for surgery, some patients experience sense of fear, unpleasantness and embarrassment due to the expectance of adverse consequences of surgical intervention. Recently an instrument for measuring fear of surgery - the Surgical Fear Questionnaire (SFQ) - was developed and validated on a sample of Dutch patients awaiting surgery. The objective of this study was to translate the SFQ to Serbian language, make cultural adaptation of the translation and test its reliability and validity in a sample of outpatients in Serbia. Methods. The SFQ was translated and adapted according to the accepted international standards (double forward translation, harmonization, backward translation, and piloting). The study was multicentric, involving patients from 7 cities in 3 countries: Serbia, Montenegro, Bosnia and Hercegovina. It was conducted at state-owned health facilities. The sample was of consecutive nature and consisted of 330 outpatients who visited specialists of either internal medicine or general surgery. Results. Translated SFQ showed excellent reliability, both when rated by the investigators (Cronbach's alpha 0.915), and by the patients themselves (Cronbach's alpha 0.917). It is temporally stable, and both divergent and convergent validity tests had good results. Factorial analysis revealed one domain on the whole study sample and two domains like in original on the subsample of patients without experience with surgery in general anesthesia. Conclusion. Identification of patients with high level of fear of surgery by this questionnaire should help clinicians to administer measures which may decrease fear and prevent avoidance of absolutely necessary surgery by such patients. [ABSTRACT FROM AUTHOR]