Complications of Groin Hernia and of Hernial Repair

Background: In the practice of General Surgery, hernia repair is the second most common procedure after appendectomy. Several methods have been developed over the years to try to improve hernia repair. Good result can be expected using Bassini's, McVay's, Shouldice's techniques provided the exact nature of hernia is recognized and the repair is done without tension using healthy tissue. The introduction of synthetic mesh started a new era in hernia surgery. The use of synthetic mesh repair of primary and recurrent hernias has gradually gained acceptance among surgeons. Objective: To find out the outcome and complications of open inguinal hernia repair with prolene mesh. Methods: This is a prospective cross sectional study conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from December, 2011 to May, 2012. One hundred patients of inguinal hernia admitted in different surgical units of BSMMU, Dhaka for elective surgery were studied. We have given 1 gm ijv Cephradine per operatively and then 500 gm cephradine ijv 6 hourly for 24 hours followed by oral form of Cephradine for next 5 days. Polypropylene mesh of 11 cm x 7 cm size was used in all cases. All the operations were done by open tension free prolene mesh repair technique. Patients were followed for one year to see the outcome. Results: Out of 100 cases of inguinal hernia, 71 patients (71%) had indirect inguinal hernia and 29 cases (29%) had direct inguinal hernia; 90 cases (90%) were primary hernia and only 10 cases (10%) were recurrent hernia; 58 cases were right sided, 34 cases (34%) were left sided and 8 cases (8%) were bilateral. Complications of mesh repair of groin hernia in this study included wound infection (5%), scrotal oedema (2%), mesh infection (0%), scrotal hematoma (2%), echymoces of peri-incisional skin (5%), early wound and groin pain (7%), chronic inguinodynia (2%), hernia recurrence (1%). Conclusion: In the present study an attempt is made to evaluate the outcome of patients undergoing inguinal hernia repair by prolene mesh. The results confirm that Lichtenstein tension free mesh repair of inguinal hernia is safe and reliable for both primary and recurrent groin hernia, with less recurrence rate. Patient's compliance was good with minimum morbidity. Journal of Surgical Sciences (2018) Vol. 22 (1): 21-24

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Laparoscopic repair of inguinal hernia: Prospective evaluation at a tertiary care center

Journal of Surgical Sciences ◽

10.3329/jss.v23i2.46111 ◽

2020 ◽

Vol 23 (2) ◽

pp. 54-58

Author(s):

ABM Mahbubur Rahman ◽

Tamjeed Alam ◽

AHM Shamsul Alam ◽

Fahim Ferdaus ◽

Gazi Gias Uddin

Keyword(s):

Chronic Pain ◽

Inguinal Hernia ◽

Hernia Repair ◽

Groin Hernia ◽

Tertiary Care ◽

Groin Hernia Repair ◽

Groin Hernias ◽

Laparoscopic Groin Hernia Repair ◽

Repair Techniques

Background: Treatment of groin hernias continues to evolve. The emergence of laparoscopic inguinal hernia surgery has challenged the conventional gold standard Lichtenstein’s tension free mesh repair. Laparoscopic technique to achieve surgical correction over groin hernia is increasingly being practiced in our country, and it is imperative to test the overall outcome of this technique in a tertiary care setting. Objectives: Current study was aimed at evaluating the per-operative events, early and late outcomes of laparoscopic groin hernia repair techniques. End points of evaluation were postoperative pain, hospital stay, resumption of normal activities, chronic pain and recurrence. Methods: Within a 2-year period, 45 patients of groin hernias of different clinical types underwent laparoscopic inguinal hernia repair in Bangladesh Medical College Hospital were recruited in this prospective observational study. Preoperative findings, intraoperative course, postoperative and follow-up data were analyzed to evaluate the outcomes. Observations were made regarding operating time, operative hazards, postoperative pain, incidence of early post-operative morbidities, hospital stay, resumption of activities. Total 24 months follow-up was carried out with regards to normal activity, late complications notably chronic groin pain and recurrence. Results: The mean age of 38.1±11.1 years, 27(60%) patients underwent TEP repair whereas, TAPP procedure was carried out in 18 patients (40%). For unilateral hernia repair using TEP technique, mean operative time was 50.3±4.2 mints and 61.7±5.3 mints for direct and indirect variety (D/I), with the corresponding rates for TAPP repair being 65.0±2.2 mints and 72.8±3.2 mints (D/I) respectively. Conversion rate to other operative procedure was 6.67%. The overall surgery related early post-operative morbidity was 7.4% (TEP) and 16.8% (TAPP). 3 out of 45 patients (6.67%) experienced chronic pain in the groin in the study. However, there was no single incidence of recurrence observed during the follow up period. Conclusion: Laparoscopic groin hernia repair techniques are safe and feasible, offers the benefits of minimally invasive surgery and becoming the procedure of choice specially for bilateral and recurrent inguinal hernias. Journal of Surgical Sciences (2019) Vol. 23(2): 54-58

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Laparoscopic Groin Hernia Repair: Is The Learning Curve Really Long?

Indian Journal Of Applied Research ◽

10.15373/2249555x/sep2012/60 ◽

2011 ◽

Vol 1 (12) ◽

pp. 171-173

Author(s):

Dr. P A Yavalkar Dr. P A Yavalkar ◽

◽

Dr. S E Jadhav Dr. S E Jadhav

Keyword(s):

Hernia Repair ◽

Learning Curve ◽

Groin Hernia ◽

Groin Hernia Repair ◽

Laparoscopic Groin Hernia Repair

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A Clinical Study to Evaluate the Clinical Performance and Safety of LiquiBand FIX8® Versus AbsorbaTack™ for Hernia Mesh Fixation and Peritoneal Closure in Groin Hernia Repair

Case Medical Research ◽

10.31525/ct1-nct04009213 ◽

2019 ◽

Author(s):

Keyword(s):

Clinical Study ◽

Hernia Repair ◽

Groin Hernia ◽

Clinical Performance ◽

Mesh Fixation ◽

Groin Hernia Repair ◽

Hernia Mesh ◽

Peritoneal Closure

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Faculty Opinions recommendation of Chronic groin pain, discomfort and physical disability after recurrent groin hernia repair: impact of anterior and posterior mesh repair.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.725953073.793533330 ◽

2017 ◽

Author(s):

Darin Correll

Keyword(s):

Hernia Repair ◽

Physical Disability ◽

Mesh Repair ◽

Groin Hernia ◽

Groin Pain ◽

Chronic Groin Pain ◽

Groin Hernia Repair ◽

Recurrent Groin

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Longitudinal cohort study on preoperative pain as a risk factor for chronic postoperative inguinal pain after groin hernia repair at 2-year follow-up

Hernia ◽

10.1007/s10029-021-02404-w ◽

2021 ◽

Author(s):

B. Romain ◽

◽

T. Fabacher ◽

P. Ortega-Deballon ◽

L. Montana ◽

...

Keyword(s):

Risk Factor ◽

Cohort Study ◽

Hernia Repair ◽

Groin Hernia ◽

Longitudinal Cohort Study ◽

Groin Hernia Repair ◽

Preoperative Pain ◽

Longitudinal Cohort ◽

Chronic Postoperative Inguinal Pain

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Natural course of long-term postherniorrhaphy pain in a population-based cohort

Scandinavian Journal of Pain ◽

10.1016/j.sjpain.2009.09.012 ◽

2010 ◽

Vol 1 (1) ◽

pp. 55-59 ◽

Cited By ~ 6

Author(s):

Gabriel Sandblom ◽

Maija-Liisa Kalliomäki ◽

Ulf Gunnarsson ◽

Torsten Gordh

Keyword(s):

Multivariate Analysis ◽

Postoperative Pain ◽

Hernia Repair ◽

Groin Hernia ◽

Population Based ◽

Persistent Pain ◽

Natural Course ◽

Hernia Surgery ◽

Persistent Postoperative Pain ◽

Postherniorrhaphy Pain

AbstractBackgroundPersistent pain after hernia repair is widely recognised as a considerable problem, although the natural course of postoperative pain is not fully understood. The aim of the present study was to explore the natural course of persistent pain after hernia repair in a population-based cohort and identify risk factors for prolonged pain duration.MethodsThe study cohort was assembled from the Swedish Hernia Register (SHR), which has compiled detailed information on more than 140 000 groin hernia repairs since 1992. All patients operated on for groin hernia in the County of Uppsala, Sweden, 1998–2004 were identified in the SHR. Those who were still alive in 2005 received the Inguinal Pain Questionnaire, a validated questionnaire with 18 items developed with the aim of assessing postherniorrhaphy pain, by mail. Reminders were sent to non-responders 5 months after the first mail. The halving time was estimated from a linear regression of the logarithmic transformation of the prevalence of pain each year after surgery. A multivariate analysis with pain persisting more than 1 month with a retrospective question regarding time to pain cessation as dependent variable was performed.ResultsAltogether 2834 repairs in 2583 patients were recorded, 162 of who had died until 2005. Of the remaining patients, 1763 (68%) responded to the questionnaire. In 6.7 years the prevalence of persistent pain had decreased by half for the item “pain right now” and in 6.8 years for the item “worst pain last week”. The corresponding figures if laparoscopic repair was excluded were 6.4 years for “pain right now” and 6.4 years for “worst pain past week”. In a multivariate analysis, low age, postoperative complication and open method of repair were found to predict an increased risk for pain persistence exceeding 1 month.ConclusionPersistent postoperative pain is a common problem following hernia surgery, although it often recedes with time. It is more protracted in young patients, following open repair and after repairs with postoperative complications. Whereas efforts to treat persistent postoperative pain, in particular neuropathic pain, are often fruitless, this group can at least rely on the hope that the pain, for some of the patients, gradually decreases with time. On the other hand, 14% still reported a pain problem 7 years after hernia surgery. We do not know the course after that.Although no mathematical model can provide a full understanding of such a complex process as the natural course of postoperative pain, assuming an exponential course may help to analyse the course the first years after surgery, enable comparisons with other studies and give a base for exploring factors that influence the duration of the postoperative pain. Halving times close to those found in our study could also be extrapolated from other studies, assuming an exponential course.

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