scholarly journals Effectiveness of fibrin glue in comparision to polypropylene suture for mesh fixation in lichtenstein inguinal hernia repair

2019 ◽  
Vol 6 (4) ◽  
pp. 1305
Author(s):  
Rajkumar Parameshwar Narayanakar ◽  
Kushal Kumar Talagavara Radhakrishna ◽  
Madhuri G. Naik
Keyword(s):  
Hernia Repair ◽  
Fibrin Glue ◽  
Groin Pain ◽  
Mesh Fixation ◽  
Chronic Groin Pain ◽  
Human Beings ◽  
Common Procedure ◽  
Lichtenstein Hernia Repair ◽  
Duration Of Surgery ◽  
Acceptable Method

Background: Hernia is one of the oldest maladies known and suffered by humans. It has been known since ages and will be known for centuries to come as long as human beings prompt to stand and walk. Lichtenstein hernia repair is the most common procedure followed surgery but with some devastating complications such as chronic groin pain (CGP). The search for the most appropriate method to fix mesh and to reduce complications is still on and this study aims for the same.Methods: A comparative prospective study conducted in Department of General Surgery, Bangalore medical college & Research institute from November-2016 to May-2018. 100 patients falling into inclusion criteria were taken to study with randomization, 50 in each group (prolene vs Fibrin-glue). Postoperatively patient was assessed for complications, recovery time and Data collected was statistically analyzed using appropriate statistical test and p<0.05 was taken significant.Results: Most common age group presenting with hernia was from 41-50 years (29%) with M: F ration 5.6:1. Laterality being right: left: bilateral:: 58%: 36% :6% respectively. Type of hernia being Indirect: Direct:: 66%: 34% respectively. Duration of surgery, recovery to ADL and postoperative complications like seroma, chronic groin pain, foreign-body sensation was significantly less with fibrin glue compared to prolene group. Postoperative Haematoma, local numbness and recurrence were comparable and the difference in the result was statistically insignificant.Conclusions: Through our study from the above-mentioned benefits, it can be concluded that use of fibrin Glue in mesh fixation is a safe and acceptable method and can be used as a better alternative for prolene suture for mesh fixation in Liechtenstein’s hernioplasty.

scholarly journals A prospective study comparing prophylactic division versus preservation of the ilioinguinal nerve in open Lichtenstein inguinal hernioplasty

2021 ◽  
Vol 8 (2) ◽  
pp. 524
Author(s):  
Waleed Yusif El-Sherpiny ◽  
Tamer M. Elmahdy ◽  
Hosam Barakat Barakat
Keyword(s):  
Hernia Repair ◽  
Groin Pain ◽  
Randomized Study ◽  
Major Complication ◽  
Chronic Groin Pain ◽  
University Hospitals ◽  
Inguinal Hernioplasty ◽  
Ilioinguinal Nerve ◽  
Nerve Preservation ◽  
Lichtenstein Hernia Repair

Background: Inguinal hernia is one of the most common surgeries done all over the world. Chronic groin pain is one of the most annoying problems after mesh hernioplasty. This study aimed at evaluating the incidence of chronic groin pain and numbness occurring after prophylactic ilioinguinal neurectomy, as compared to its preservation during Lichtenstein’s inguinal hernioplasty. Methods: This prospective randomized study involved 90 patients complaining of inguinal hernias admitted to the department of general surgery, Tanta university hospitals during the study period. Our patients were divided randomly in two equal groups. (Group A) patients were subjected to Lichtenstein hernia repair with ilioinguinal neurectomy while (group B) patients were subjected to Lichtenstein hernia repair with nerve preservation. Post-operatively the incidence of groin pain and numbness were assessed in all patients. The pain was evaluated using a visual analogue scale. Whereas numbness was examined by the monofilament test and evaluated in comparison to the opposite side.Results: In the present study, the incidence of pain was higher in nerve preservation study group whereas, numbness was not a major complication after prophylactic ilioinguinal nerve division and did not add to patient morbidity.Conclusions: Prophylactic ilioinguinal nerve division could be an appropriate and beneficial solution for chronic groin pain after the Lichtenstein procedure and may be added as a surgical step during the classic procedures for hernia repair. Also, numbness was not a major complication after the prophylactic division of the ilioinguinal nerve and did not add to the patient morbidity.

scholarly journals A comparative study of mesh fixation with polypropylene sutures (prolene) versus polyglactin sutures (vicryl) sutures in assessing inguinodynia in open inguinal hernia repair

2021 ◽  
Vol 8 (3) ◽  
pp. 904
Author(s):  
Ramesh S. Koujalagi ◽  
Vinod Karagi ◽  
Abhijit S. Gogate ◽  
Nikhil M.
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Groin Pain ◽  
Mesh Fixation ◽  
Chronic Groin Pain ◽  
Post Operative Pain ◽  
Severity Scores ◽  
Group A ◽  
Polypropylene Sutures

Background: Inguinal hernia, the most frequently occurring type of hernia globally, Chronic groin pain could be related to nerve mangling while operating. Mesh repair can lead to an inflammatory reaction over a period of time, though it still needs ground work to find out exact cause of pain. So this study aims to compare the effectiveness of polyglactin versus prolene sutures in reducing the post-operative pain in inguinal hernia repair.Methods: A one year hospital prospective study in KLE hospital. A total of 60 adult patients were divided into two groups of 30 each. Mesh fixation with polyglactin sutures was group A (30) and mesh fixation with polypropylene sutures was group B (30) and then post-operative pain, was assessed. Follow-up was for 3 months. Collected data was analyzed using chi–square tests, Mann-Whitney U tests.Results: Our analysis showed that the incidence of postoperative groin pain with mean severity scores of 1.37±0.49 versus 1.43±0.50; 1.40±0.50 versus 1.57±0.73; 1.03±0.61 versus 1.50±0.057; 0.77±0.63 versus 1.30±0.79; at post-operative day 1, 3 in both groups were similar and statistically not significant whereas the 1 week and 3 months follow up in group A and B respectively, were significant (p<0.05).Conclusions: The post-op chronic groin pain is significantly low, hence routine usage of polyglactin sutures to fix a mesh is a safe and effective alternative to polypropylene sutures in Lichtenstein hernia repair.

Factors Determining Outcome After Surgery for Chronic Groin Pain Following a Lichtenstein Hernia Repair

2015 ◽  
Vol 39 (11) ◽  
pp. 2652-2662 ◽  
Author(s):  
Willem A. R. Zwaans ◽  
Tim Verhagen ◽  
Rudi M. H. Roumen ◽  
Marc R. M. Scheltinga
Keyword(s):  
Hernia Repair ◽  
Groin Pain ◽  
Chronic Groin Pain ◽  
Lichtenstein Hernia Repair

Evaluation of Chronic Groin Pain Rates After TEP Hernioplasty – A Single-Center Study

2019 ◽  
Vol 12 (2) ◽  
pp. 153-156
Author(s):  
Dobromir D. Dimitrov
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Groin Pain ◽  
Mesh Fixation ◽  
University Hospital ◽  
Chronic Groin Pain ◽  
Minimal Risk ◽  
Preoperative Pain ◽  
Total Extraperitoneal

Summary Total extraperitoneal hernioplasty (TEP) has become increasingly used by surgeons. The TEP procedure is technically more challenging due to space constraints and has a higher learning curve. Chronic groin pain after inguinal hernia repair has become the dominant outcome investigated rather than recurrence. We aimed to evaluate the rate of chronic groin pain after TEP inguinal hernia repair performed at the Department of Surgical Oncology in G. Stranski University Hospital – Pleven. The procedures performed totaled 36. There was one conversion, and the patient was excluded from the study because the procedure performed was not laparoscopic. Distribution according to inguinal hernia type was: 41.7% - indirect hernia (15), 36.1% - direct hernia (13), 13.9% combined (5), and 8.3% femoral (3). Twenty-eight of the patients (80%) had preoperative pain. Two of the patients with chronic groin pain had had their meshes fixed with tacks (14.3% from the tack group with p=0.7). Our study showed that the TEP procedure is a safe, feasible operation with minimal risk for complications. Using tacks for mesh fixation is associated with higher rates of chronic groin pain, but it does not affect the recurrence rate, which correlates with the literature review data.

scholarly journals Ilioinguinal Nerve Neurectomy is better than Preservation in Lichtenstein Hernia Repair: A Systematic Literature Review and Meta-analysis

2021 ◽  
Author(s):  
Roberto Cirocchi ◽  
Marco Sutera ◽  
Piergiorgio Fedeli ◽  
Gabriele Anania ◽  
Piero Covarelli ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Groin Pain ◽  
Meta Analysis ◽  
Group Versus ◽  
Chronic Groin Pain ◽  
Ilioinguinal Nerve ◽  
Nerve Preservation ◽  
Lichtenstein Hernia Repair

Abstract Objective This study aimed to evaluate the incidence of chronic groin pain (primary outcome) and alterations of sensitivity (secondary outcome) after Lichtenstein inguinal hernia repair, comparing neurectomy with ilioinguinal nerve preservation surgery. Summary background data The exact cause of chronic groin postoperative pain after mesh inguinal hernia repair is usually unclear. Section of the ilioinguinal nerve (neurectomy) may reduce postoperative chronic pain. Methods We followed PRISMA guidelines to identify randomized studies reporting comparative outcomes of neurectomy versus ilioinguinal nerve preservation surgery during Lichtenstein hernia repairs. Studies were identified by searching in PubMed, Scopus, and Web of Science from April 2020. The protocol for this systematic review and meta-analysis was submitted and accepted from PROSPERO: CRD420201610. Results In this systematic review and meta-analysis, 16 RCTs were included and 1550 patients were evaluated: 756 patients underwent neurectomy (neurectomy group) vs 794 patients underwent ilioinguinal nerve preservation surgery (nerve preservation group). All included studies analyzed Lichtenstein hernia repair. The majority of the new studies and data comes from a relatively narrow geographic region; other bias of this meta-analysis is the suitability of pooling data for many of these studies. A statistically significant percentage of patients with prosthetic inguinal hernia repair had reduced groin pain at 6 months after surgery at 8.94% (38/425) in the neurectomy group versus 25.11% (113/450) in the nerve preservation group [relative risk (RR) 0.39, 95% confidence interval (CI) 0.28–0.54; Z = 5.60 (P < 0.00001)]. Neurectomy did not significantly increase the groin paresthesia 6 months after surgery at 8.5% (30/353) in the neurectomy group versus 4.5% (17/373) in the nerve preservation group [RR 1.62, 95% CI 0.94–2.80; Z = 1.74 (P = 0.08)]. At 12 months after surgery, there is no advantage of neurectomy over chronic groin pain; no significant differences were found in the 12-month postoperative groin pain rate at 9% (9/100) in the neurectomy group versus 17.85% (20/112) in the inguinal nerve preservation group [RR 0.50, 95% CI 0.24–1.05; Z = 1.83 (P = 0.07)]. One study (115 patients) reported data about paresthesia at 12 months after surgery (7.27%, 4/55 in neurectomy group vs. 5%, 3/60 in nerve preservation group) and results were not significantly different between the two groups [RR 1.45, 95% CI 0.34, 6.21;Z = 0.51 (P = 0.61)]. The subgroup analysis of the studies that identified the IIN showed a significant reduction of the 6th month evaluation of pain in both groups and confirmed the same trend in favor of neurectomy reported in the previous overall analysis: statistically significant reduction of pain 6 months after surgery at 3.79% (6/158) in the neurectomy group versus 14.6% (26/178) in the nerve preservation group [RR 0.28, 95% CI 0.13–0.63; Z = 3.10 (P = 0.002)]. Conclusion Ilioinguinal nerve identification in Lichtenstein inguinal hernia repair is the fundamental step to reduce or avoid postoperative pain. Prophylactic ilioinguinal nerve neurectomy seems to offer some advantages concerning pain in the first 6th month postoperative period, although it might be possible that the small number of cases contributed to the insignificancy regarding paresthesia and hypoesthesia. Nowadays, prudent surgeons should discuss with patients and their families the uncertain benefits and the potential risks of neurectomy before performing the hernioplasty.

Fibrin Glue Mesh Fixation in Hernia Repair

2007 ◽  
Vol 246 (5) ◽  
pp. 906-908 ◽  
Author(s):  
Bengt Novik
Keyword(s):  
Hernia Repair ◽  
Fibrin Glue ◽  
Mesh Fixation

scholarly journals Ilio inguinal neurectomy in inguinal hernia

2017 ◽  
Vol 4 (9) ◽  
pp. 2977
Author(s):  
T. Mohanapriya ◽  
T. R. Karthikeyan ◽  
K. Balaji Singh ◽  
T. Arulappan
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Controlled Trial ◽  
Chronic Groin Pain ◽  
Study Group ◽  
Ilioinguinal Nerve ◽  
Nerve Preservation ◽  
Significant Complication ◽  
Lichtenstein Hernia Repair ◽  
Surgery Department

Background: Inguinal hernia is one of the most common surgery done in any hospital. Chronic inguinal pain is one of the common problem these patients complain of. This study aims at evaluating the long-term outcomes of neuralgia and paraesthesia following routine ilioinguinal nerve division, compared to nerve preservation when performing Lichtenstein’s inguinal hernia repair.Methods: The present study is a randomized controlled trial of 60 cases of inguinal hernias admitted in General Surgery Department in our hospital. The patients were randomly chosen into Lichtenstein hernia repair with ilioinguinal neurectomy or Lichtenstein hernia repair with nerve preservation. After surgery, all patients were monitored carefully for pain and paraesthesia. Pain was assessed using visual analogue scale. Paraesthesia was assessed by the monofilament test and evaluated after comparison with the opposite side.Results: In the present study, the incidence of pain as well as the severity of pain is far higher in the nerve preservation study group as opposed to the neurectomy study group. Hypaesthesia is not a significant complication following ilioinguinal neurectomy and does not significantly add to the morbidity of the patient.Conclusions: Prophylactic neurectomy can be an appropriate solution in the prevention of chronic groin pain following Lichtenstein inguinal hernia repair and can be considered as an ideal inclusion into the standard hernia repair procedures. Hypoesthesia is not a significant complication following ilioinguinal neurectomy and does not significantly add to the morbidity of the patient.

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