The presence of a low lying pubic tubercle in patients with indirect inguinal hernia

Background: Among all external abdominal hernias, inguinal hernia is one most commonly encountered. Factors like chronic cough, constipation, prostatic enlargement etc. contribute to its development. Various defensive mechanisms of the inguinal canal like shutter and slit valve mechanisms help prevent its formation. In this study, a comparison has been made between the anthropometric measurements of the pelvis in patients with and without indirect inguinal hernia to look for a statistically significant difference in the position of the pubic tubercle which in turn affects the various protective mechanisms. Other measurements such as Height, Weight and interspinal distance have been included to look for positive correlations between the disease and said measurements.Methods: This study was conducted in the General Surgery Department of SRM Hospital, Medical College and Research Centre, Kattankulathur after ethics committee clearance. It is a case control study conducted on 140 consenting patients and meeting the inclusion criteria from March 2016 to August 2017, of which 70 each were patients of indirect inguinal hernia and patients without inguinal hernia.Results: Results developed using SPSS Software show majority of the subjects with a low lying pubic tubercle were inguinal hernia patients. There was also a positive correlation between the ratios of weight and ST length as well as Height and ST length between cases and controls.Conclusions: It can be concluded from this study that factors such as a low lying pubic tubercle and other related anthropometric variables predispose patients to develop indirect inguinal hernia.

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The results of preperitoneal inguinal hernioplasty without fixation of the mesh endoprosthesis in the experiment.

Vestnik of Experimental and Clinical Surgery ◽

10.18499/2070-478x-2019-12-2-97-101 ◽

2019 ◽

Vol 12 (2) ◽

pp. 97-101

Author(s):

Anna Viktorovna Mokrova ◽

Oleg Vladimirovich Zaitsev ◽

Dmitry Anatolyevich Khubezov ◽

Vladimir Alexandrovich Yudin ◽

Sergey Vasilevich Tarasenko ◽

...

Keyword(s):

Inguinal Hernia ◽

Inguinal Canal ◽

Abdominal Cavity ◽

Preperitoneal Space ◽

Indirect Inguinal Hernia ◽

Inguinal Hernioplasty ◽

Experimental Development ◽

Direct Inguinal Hernia ◽

Significant Difference ◽

Mesh Endoprosthesis

The purpose of the study is experimental development of preperitoneal inguinal hernioplasty with synthetic mesh, according assessment of the need of its fixation to the tissues. Materials and methods. An inguinal hernia was simulated on human cadaveric material. The study used 27 male corpses. Two inguinal hernias were modeled on one corpse: on one side - indirect, on the other - direct. A polypropylene mesh (standard density, 15 x 15 cm) was placed in the preperitoneal space. The endoprosthesis was impacted from the side of the abdominal cavity by a special designed device. The effect of a peak intra-abdominal pressure of 200 mm Hg was simulated. The degree of displacement of the reticular endoprosthesis into the inguinal canal was estimated at the moment of peak pressure on it from inside the abdominal cavity. For a simulated indirect inguinal hernia, two variants of the technique were considered: with fixation of the endoprosthesis to the underlying tissues and without fixation. For the modulated direct inguinal hernia, the following options were considered: non-fixative, with fixation at one point to the pubis and with plasty of the transverse fascia. Results. When modeling preperitoneal plasty of a direct inguinal hernia, there is a pronounced displacement of the endoprosthesis into the inguinal canal with a non-fixing plasty, unlike the method with transverse fascia plasty or fixation to the pubis. In indirect inguinal hernia, there was no significant displacement of the endoprosthesis in both considered variants. Conclusions. According to the obtained results, conclusions were drawn on the need for additional plasty of the transverse fascia or fixation of the endoprosthesis at a single point in a direct inguinal hernia. With indirect inguinal hernia in the experiment, no significant difference in the displacement of the mesh endoprosthesis into the inguinal canal was obtained with and without fixation.

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An experience of workshop on introduction to statistical methods and SPSS hands-on training to enhance analytical skills among research professionals

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20174855 ◽

2017 ◽

Vol 4 (11) ◽

pp. 4337

Author(s):

Laxmi Tellur ◽

Vijaya Sorganvi ◽

M. C. Yadavannavar

Keyword(s):

Statistical Methods ◽

Research Centre ◽

Teaching Methodology ◽

Multiple Choice Questions ◽

College Hospital ◽

Medical College ◽

Significant Difference ◽

Hands On ◽

Post Test ◽

The Impact

Background: In a current scenario, research project and writing a thesis is one of the most important components of PG and Ph.D. studies and a potential area where the students are challenged by lack of structured guidance. Thus the workshop on “Introduction to Statistical Methods & ‘SPSS’ Hands-on Training” was conducted with the objectives, to know the impact of workshop and to obtain suggestions for improvement.Methods: The workshop on “Introduction to Statistical Methods & ‘SPSS’ Hands-on Training” conducted during 7-9 November, 2016 by the Department of Community Medicine, Shri B. M. Patil Medical College, Hospital and Research Centre in collaboration with University of Manitoba, Canada. The effectiveness of the workshop was assessed by pre-and-post tests using Multiple-Choice Questions (MCQ). Analysis was done using paired t test and Wilcoxon signed rank test.Results: A total of thirty six participants attended the sessions. The overall participant opinion about the workshop was positive. Majority of the participants were female. Majority of the participants were in the age group of 30-35 years (33%), followed by 25-30 years (28%). Majority of participants were MBBS (31%), MD (28%), other degree faulty members (22%) and PhD (22%). The mean score in pre-and-post-test was 12.52±6.17 and 13.98±6.50 respectively (Range=2-27) and was found significant difference in the scores between pre-and-post-tests (p=0.002).Conclusions: The recommendations and suggestions given by workshop participants were to increase the duration of the workshop. Participants were satisfied with the teaching methodology in the workshops.

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Prospective comparison of post-operative quality of life (QOL) after laparoscopic total extra-peritoneal (TEP) and trans-abdominal pre-peritoneal (TAPP) repair of indirect inguinal hernia

International Surgery Journal ◽

10.18203/2349-2902.isj20183208 ◽

2018 ◽

Vol 5 (8) ◽

pp. 2882

Author(s):

Nikita Wadhwani ◽

Ishwar Chand Mehar ◽

Arun Singh ◽

R. K. Soni

Keyword(s):

Quality Of Life ◽

Inguinal Hernia ◽

P Value ◽

Indirect Inguinal Hernia ◽

Statistical Significant Difference ◽

Tapp Repair ◽

Significant Difference ◽

Operative Quality

Background: As the laparoscopic method is becoming a popular choice of repair, the need to evaluate its impact on the patient’s quality of life (QOL) is also warranted. This study was undertaken to compare post operative QOL in patients undergoing Totally Extraperitoneal (TEP) and Transabdominal preperitoneal (TAPP) repair for indirect inguinal hernia.Methods: This prospective observational study was conducted in the Department of General Surgery at VMMC and Safdarjung Hospital, from June 2016 to March 2018. Patients with uncomplicated indirect inguinal hernia were included in the study after obtaining their informed consent. Post-operative QOL was evaluated using EuraHS-QOL scale at 24 hours and 1, 3 and 6 months after the surgery.Results: A total of sixty patients were enrolled-30 in TEP group and 30 in TAPP group. There was no statistical significant difference in scores at 24 hours follow-up except cosmetic discomfort domain, with higher scores in TAPP (p-value=0.014). Statistical significant difference was present at 1 month follow up with higher scores in TAPP (p-value=0.011). At 3 and 6 months, no statistical difference was found in the scores.Conclusions: Present study demonstrates a significant advantage of TEP over TAPP up to 1-month follow-up, in terms of post-operative QOL. Choosing a superior laparoscopic method between TEP and TAPP requires high powered RCTs with long term follow up to assess the technical advantages and post-operative complications along with post-operative quality of life in patients.

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Comparative study of efficacy of nifedipine, nitroglycerin dermal patches and isoxsuprine as tocolytic agents in suppression of preterm labour 1-year study at navodaya medical college hospital and research centre Raichur

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20212672 ◽

2021 ◽

Vol 10 (7) ◽

pp. 2806

Author(s):

Rita D. ◽

V. Haripriya

Keyword(s):

Side Effects ◽

Preterm Labour ◽

Research Centre ◽

College Hospital ◽

Treatment Groups ◽

Medical College ◽

Uterine Contractions ◽

Significant Difference ◽

Tocolytic Agent ◽

Tocolytic Agents

Background: Tocolytic agents are used to reduce preterm deliveries. Very few studies documenting the comparison of tocolytic agents viz. nifedipine, nitroglycerin dermal patches and isoxsuprine. Other drugs are not used due to their adverse effects. Objective was to study and compare the safety efficacy of nifedipine, nitroglycerin dermal patches and isoxsuprine as tocolytic agents in suppression of preterm labour 1 year study.Methods: This was a prospective case control study was conducted for a period of 1 year. Total 90 cases selected to study were randomly distribute in to three treatment groups viz. A, B, and C nifedipine, nitroglycerin and isoxsuprine respectively. Subjects in all three groups were evaluated for maternal pulse rate, palpitation uterine contractions and fetal heart rate in order to assess efficacy of each drug under investigation.Results: There was no statistically significant difference in age of woman’s in three different groups. Among (100%) subjects, majority of the cases i.e. (27.8%) primi gravida followed by multi (72.2%). Side effects of nifedipine was less when compared to nitroglycerine dermal patch and isoxsuprine i/v/o of headache (8.9%), nausea (1.1%), vomiting (1.1%), tachycardia (3.3%), palpitation (3.3%), hypotension (1.1%). side effects were statistically significant different between the treatment groups. There was no statistically significant difference with respect to APGAR score at 1 minute and 5 minutes.Conclusions: Oral nifedipine was found to be superior and efficacious as tocolytic agent as compared to transdermal nitroglycerin and intravenous isoxsuprine.

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Pattern of abdominal wall hernia attended in Fishtail Hospital, Pokhara, Nepal

Journal of Chitwan Medical College ◽

10.3126/jcmc.v8i2.23735 ◽

2018 ◽

Vol 8 (2) ◽

pp. 32-36

Author(s):

Pradeep Ghimire ◽

Bishowdeep Timilsina

Keyword(s):

Inguinal Hernia ◽

Abdominal Wall ◽

Striated Muscle ◽

Abdominal Wall Hernia ◽

Research Centre ◽

Indirect Inguinal Hernia ◽

Weak Spot ◽

Demographic Profiles ◽

Different Types ◽

Ethical Clearance

Introduction: All hernias are caused by a combination of pressure and an opening or weakness of muscle or fascia. The pressures push an organ or tissue through the opening or weak spot. Sometimes muscle weakness is present at birth; more often it occurs later in life. Abdominal wall hernias occur only at sites at which the aponeurosis and fascia are not covered by striated muscle. The aim of the study was to know different pattern of abdominal hernias, to analyze various clonal and demographic profiles of various abdominal wall hernias presenting to the mid-western part of Nepal and to evaluate different types of operation and complication performed in hernias patients. Methods: Hospital based retrospective descriptive study performed in Fishtail Hospital and Research Centre, Pokhara Nepal in October 2012 to July 2017. Ethical clearance was taken from institute and written consent was taken from all the patients who are involved in the study. All sociodemographic data were collected and analyzed by using SPSS 20 statistical software. Results: In this study period, 492 patients of various types of hernias were operated by various methods. Most common type of hernia is indirect inguinal hernia (94.39%) and one rare spigelian hernia was also there. Right inguinal hernia was more common (58.42%). Conclusion: Inguinal Hernia was the commonest type of hernia (394, 90.3%). Among inguinal hernia right side was more common (58.42%). Among inguinal hernias, most of the hernias were found in 0-9 years (38.21%). In this study we found recurrence rate 1.4%.

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Comparison of post-operative pain after laparoscopic total extraperitoneal mesh repair of indirect inguinal hernia with tacker

10.53350/pjmhs2115102733 ◽

2021 ◽

Vol 15 (10) ◽

pp. 2733-2735

Author(s):

Shahid Hussain ◽

Asiya Shabbir ◽

Muhammad Asif

Keyword(s):

Inguinal Hernia ◽

Mesh Repair ◽

Indirect Inguinal Hernia ◽

Satisfactory Outcome ◽

Post Operative Pain ◽

Total Extraperitoneal ◽

Significant Difference ◽

Group A ◽

Group B ◽

Laparoscopic Tep

Objectives: To compare the post-operative pain after laparoscopic total extraperitoneal mesh repair of indirect inguinal hernia with tacker and without tacker fixation. Materials & Methods: This comparative study was done at Surgical Department of Bahawal Victoria Hospital, Bahawalpur from May 2020 to November 2020 over the period of 6 months. Total 182 patients with indirect inguinal hernia, having age range from 20 to 60 either male or female were selected. In group A patients, laparoscopic TEP mesh repair of inguinal hernia without tacker fixation was done while in group B patients, laparoscopic TEP mesh repair of inguinal hernia with tacker fixation was done. Patients were assessed for post-operative pain and outcome (satisfactory/unsatisfactory) at 1 month follow up. Results: Average of patients was 41.33 ± 12.37 years and 40.83 ± 12.04 years in group A and group B. Out of 182 patients, 170 (93.41%) were males and 12 (6.59%) were females. Mean post-operative pain in Group A was 1.46 ± 1.50 while in Group B was 1.77 ± 2.08 (p-value=0.2505). Satisfactory outcome was noted in 84 (92.31%) patients and 67 (73.63%) patients of group A and B and the difference was significant (P = 0.001). Conclusion: Results of this study showed that there is a significant difference of satisfactory outcome (less post-operative pain) between the non-fixation and fixation group. Difference of satisfactory outcome was also significant between male patients, diabetics and obese patients of both groups. Keywords: Inguinal hernia, laparoscopic, mesh, tacker fixation

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A randomised controlled trial of excision versus invagination in the management of indirect inguinal hernial sac

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2018.0160 ◽

2019 ◽

Vol 101 (2) ◽

pp. 119-122

Author(s):

M Sharma ◽

OP Pathania ◽

A Kapur ◽

S Thomas ◽

A Kumar

Keyword(s):

Inguinal Hernia ◽

Postoperative Pain ◽

Testicular Atrophy ◽

High Ligation ◽

Indirect Inguinal Hernia ◽

Tension Free ◽

Hernial Sac ◽

Significant Difference ◽

Group A ◽

Group B

Introduction Lichtenstein tension-free mesh hernioplasty of primary inguinal hernia is currently considered as the preferred method for the plastic reconstruction of inguinal hernia by the majority of surgeons. Several studies have examined the best way to manage the hernial sac in this surgery, but no consensus has been reached. This study was designed to compare the effects of excision of sac and invagination of sac on post-operative outcomes. Methods and methods This prospective randomised study included a total of 70 patients with primary unilateral uncomplicated indirect inguinal hernia. Group A (35 patients) underwent high dissection and invagination of the hernial sac and group B (35 patients) underwent high ligation and excision of the hernial sac. The repair of the posterior wall of the inguinal canal was done according to Lichtenstein tension-free technique. The primary outcome of this study was postoperative pain and secondary outcomes were wound infection, chronic sepsis, sinus formation, persistent pain, testicular atrophy and recurrence during the one-year follow-up period. Results There was a significant difference (P < 0.01) in pain experienced by the patients in the immediate post-operative period between the two groups; group A experienced less postoperative pain than group B. There was no significant difference in incidence of infection between the groups. Conclusions Invagination of the sac results in less postoperative pain compared with excision, with no significant difference in other postoperative outcomes.

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Role of low-lying pubic tubercle in the development of inguinal hernia

International Surgery Journal ◽

10.18203/2349-2902.isj20200284 ◽

2020 ◽

Vol 7 (2) ◽

pp. 389

Author(s):

Diwan Singh Jakhar ◽

Joginder Singh ◽

Ashok Kumar ◽

Dharmveer Jajra ◽

Sanjay Lodha

Keyword(s):

Inguinal Hernia ◽

Mean Value ◽

Oblique Muscle ◽

Pubic Tubercle ◽

Inclusion Criteria ◽

Medical College ◽

The Mean ◽

Internal Oblique ◽

Control Study

Background: Hernia is defined as abnormal protrusion of whole or a part of a viscus through the wall that contains it. Among all external abdominal hernias, inguinal hernia is one most commonly encountered. Many factors are responsible for the formation of the inguinal hernia but, what makes a few people more susceptible to this situation is still clearly not proved. The lowness of pubic tubercle is associated with narrow origin of internal oblique muscle from lateral inguinal ligament which fails to protect the deep inguinal ring consequently lead to inguinal hernia.Methods: The study was conducted in Sardar Patel Medical College and attached hospital, Bikaner for duration of 12 months from March 2018 to February 2019. It is a case-control study with 50 cases and 50 control meeting inclusion criteria. In all patients, following parameters SS line, ST line, height, weight was recorded and evaluated.Results: The mean value of ST line in our study group is 7.37±0.182 cm which is significantly greater (p=0.0001) than the controls the mean value being 7.01±0.262 cm. In our study, 98% of cases were having ST line >7.01 cm whereas 66% of controls were ST line under 7.01 cm.Conclusions: Group of people with low lying pubic tubercle are at high risk of developing inguinal hernia.

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Outcome of laparoscopic total extraperitoneal approach with direct dissection and mesh hernioplasty in the treatment of inguinal hernias

International Surgery Journal ◽

10.18203/2349-2902.isj20175904 ◽

2017 ◽

Vol 5 (1) ◽

pp. 248

Author(s):

Yousef Hisham ◽

Mannarakkal Ranjith ◽

Thommil Padinjarenalakath Nabeel ◽

Kummankandath Abbas Sidhic

Keyword(s):

Inguinal Hernia ◽

Indirect Inguinal Hernia ◽

Tep Repair ◽

Total Extraperitoneal ◽

The Mean ◽

Surgery Department ◽

Mean Time ◽

Laparoscopic Tep ◽

Mesh Hernioplasty

Background: Laparoscopic inguinal hernia repair has become increasingly popular as an alternative to open surgery. Aim: To evaluate total extraperitoneal repair with direct telescopic dissection and mesh hernioplasty for inguinal hernias.Methods: This study was conducted at General Surgery department the period of 1 year on 30 patients having inguinal hernia.Results: This prospective study included 30 adult patients with primary unilateral inguinal hernia, all of them were males. Age of study patients ranged from 22 to 64 years old. Intraoperatively, 6 patients were presented to have direct inguinal hernia (20%) while 21 patients had indirect inguinal hernia (70%). In 3 patients, combined direct and indirect hernia defects were present (10%). Mean operative time was 99.30±25.13 min. Mean time for analgesia was 3.62±1.57 days. Hospital stay mean was 1.43±0.62 days. The mean time until return to work was 14.1±3.13 days, the mean time of follow up was 7.1±2.2 months. Intra operatively 5 (15%) and post operatively 8 (26.6%)complications were observed.Conclusions: Laparoscopic TEP repair is an excellent alternative to open preperitoneal repair of inguinal hernia. Complication rate was average with other studies while there was no hernia recurrence during the period of follow up.

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A comparative study examining laparoscopic and open inguinal hernia repair in children: a retrospective study from a single center in China

BMC Surgery ◽

10.1186/s12893-020-00912-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Jie Liu ◽

XiongWei Wu ◽

WenLi Xiu ◽

XiWei Hao ◽

Jing Zhao ◽

...

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Operation Time ◽

Indirect Inguinal Hernia ◽

Bilateral Inguinal Hernia ◽

Pediatric Inguinal Hernia ◽

Advantages And Disadvantages ◽

Unilateral Inguinal Hernia ◽

Significant Difference

Abstract Background Pediatric inguinal hernia (PIH) is a common disease in children. Laparoscopic hernia repair (LHR) has developed rapidly in recent years, but there are still different opinions compared with traditional open hernia repair (OHR). The purpose of this study was to compare the advantages and disadvantages of LHR and OHR in the treatment of pediatric inguinal hernia. Methods We performed a retrospective review of all children (< 14 years) who underwent repair of inguinal hernia in the pediatric surgery center of the Affiliated Hospital of Qingdao University from January 2015 to December 2015. We collected the medical records of all the children and analyzed the clinical characteristics, operation-related information and follow-up. Results In the OHR group, 202 cases underwent unilateral inguinal hernia repair, and 43 cases underwent bilateral inguinal hernia repair. In the LHR group, 168 cases underwent unilateral inguinal hernia repair, and 136 cases underwent bilateral inguinal hernia repair. There was a significant difference in the operation time between the two groups, but there were no significant differences in postoperative hospitalization time and incidence of ipsilateral recurrent hernia between the two groups. The incidence rates of metachronous contralateral hernia (MCH) and surgical site infection in LHR group were significantly lower than those in the OHR group. Conclusion Our study shows that compared with OHR, LHR has the advantages of concealed incision, minimal invasiveness, reduced operation time, detection of contralateral patent processus vaginalis, and reduced incidence of MCH. In conclusion, LHR is safe and effective in the treatment of pediatric indirect inguinal hernia.

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