scholarly journals A comparative study of inguinal hernia using monofilament non-absorbable suture versus monofilament absorbable suture in Lichtenstein tension free hernia repair at tertiary care government hospital

2019 ◽  
Vol 6 (12) ◽  
pp. 4364
Author(s):  
Karan R. Patel ◽  
Adeesh P. Jain ◽  
Sarav C. Shah ◽  
Rahul Rathwa ◽  
Kirtan Gosai

Background: The surgical treatment of inguinal hernias has evolved through several stage, history of groin hernia is the history of surgery itself. But, chronic pain is still a major irritating post-operative complain of the patient. The objective of the present study was to compare post-operative outcomes of mesh fixation with monofilament non-absorbable v/s monofilament absorbable suture material in terms of postoperative pain, chronic groin pain, seroma formation, wound infection, scrotal oedema and recurrence in Lichtenstein hernioplasty.Methods: This is a single center, prospective randomized controlled study of 152 cases of inguinal hernia comparing post-operative outcomes of mesh fixation with monofilament non-absorbable v/s monofilament absorbable suture material in Lichtenstein hernioplasty at Baroda Medical College and S.S.G. Hospital, between 1st November 2017 to 30th November 2018.Results: Total 152 patients of unilateral or bilateral inguinal hernia were studied 76 in each group. Chronic groin pain mean visual analogue scale score at 3 months was higher in group with non-absorbable suture compared to monofilament absorbable group (1.3±0.9 v/s 0.95±0.8 p value <0.05).Conclusions: Monofilament absorbable suture is associated with less chronic groin pain and compared to monofilament non-absorbable sutures.

2020 ◽  
pp. 1-3
Author(s):  
Hamikchandra Patel ◽  
Karan Patel

Background: The surgical treatment of inguinal hernias has evolved through several stage, history of groin hernia is the history of surgery itself. But, chronic pain is still a major irritating post-operative complain of the patient. The objective of the present study was to compare post-operative outcomes of mesh fixation with monofilament non-absorbable v/s monofilament absorbable suture material in terms of postoperative pain, chronic groin pain, seroma formation, wound infection and recurrence in Lichtenstein hernioplasty. Methods: This is a single centre, prospective randomized controlled study of 152 cases of inguinal hernia comparing post-operative outcomes of mesh fixation with monofilament non-absorbable v/s monofilament absorbable suture material in Lichtenstein hernioplasty at Baroda Medical College and S.S.G. Hospital, between 1st December 2017 to 30th November 2018. Results: Total 152 patients of unilateral or bilateral inguinal hernia were studied 76 in each group. Chronic groin pain mean visual analogue scale score at 3 months was higher in group with non-absorbable suture compared to monofilament absorbable group (1.3±0.9 v/s 0.95±0.8 p value <0.05). Conclusions: Monofilament absorbable suture is associated with less chronic groin pain and compared to monofilament non-absorbable sutures.


2021 ◽  
Vol 8 (3) ◽  
pp. 904
Author(s):  
Ramesh S. Koujalagi ◽  
Vinod Karagi ◽  
Abhijit S. Gogate ◽  
Nikhil M.

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.


2018 ◽  
Vol 5 (4) ◽  
pp. 1378 ◽  
Author(s):  
Laxmi Narayan Meena ◽  
Somendra Bansal ◽  
Pradeep Verma ◽  
Rohit Rai

Background: Inguinal hernia is a one of common diagnosis which is frequently encountered in routine clinical practice. The Lichtenstein technique (tension free mesh repair) is currently the gold standard in open inguinal hernia repair. Currently chronic groin pain (Inguinodynia) is one of the common complications after hernia repair and it may affect quality of life and it has been reported in 16% to 62% of the patients.Methods: This prospective, randomized study was conducted in the department of general surgery in S.M.S. Medical College and attached group of hospitals, Jaipur from May 2014 to December 2015. All patients of 18-80 years old, who were admitted for elective inguinal hernia repair, were included for the study. Patients with bilateral, recurrent, irreducible or incarcerated hernia, pregnant patients and patients with co morbid conditions, were excluded from the study.Results: Mean age was 46.5 years in absorbable group and 45.4 years in non absorbable group. Male to female ratio was 142:13 in absorbable group and 143:12 in non absorbable group. Post operative pain was measured by VAS score. Mean postoperative pain (VAS score) was lower in absorbable sutures group as compared to non absorbable group at 3 months (0.92±0.879 vs. 1.23±1.2; p=0.013) and at 6 months (0.48±0.57 vs. 0.77±0.65; p≤0.001), which was significant.Conclusions: Patients with absorbable suture for mesh fixation has less groin pain as compared to non-absorbable suture in hernia repair during 6 months follow up period.


2019 ◽  
Vol 6 (8) ◽  
pp. 2757
Author(s):  
Santosh M. Patil ◽  
Augusty Dharmapuri

Background: Inguinal hernia repairs are one of most common surgeries performed world-wide. Inguinal hernias are present in 1.7% of the world population.Methods: Total of 100 patients was included in this study with 50 patients in each group. Group I (n=50): patients in this group underwent hernia repair using open preperitoneal mesh procedure. Group II (n=50): patients in this group underwent hernia repair using Lichtenstein procedure.Results: The proportion of patients with left inguinal hernia was higher in group I (48.00%) as compared to group II (46.00%), but this difference was not statistically significant. In overall study population (81.25%) as well as in group I (82.50%) and group II (80.00%) of the study, no history of straining was observed in the majority of the cases. Though the proportion of straining was higher in group I (32.00%) as compared to group II (26.00%), but this difference was not statistically significant (p=0.775). Chronic pain (see Table 4) was found in 28.75% of total patients, though the chronic pain was found in higher proportion of patients of group II (32.0%) as compared to group I (22.0%).Conclusions:In conclusion, this study shows that the TPT provides significant advantages over the Lichtenstein technique in case of repair of unilateral inguinal hernias. Patients in TPT group had less incidence of wound induration and chronic groin pain. They were also able to return to their jobs earlier.  


2019 ◽  
Vol 12 (2) ◽  
pp. 153-156
Author(s):  
Dobromir D. Dimitrov

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.


2017 ◽  
Vol 5 (1) ◽  
pp. 174
Author(s):  
Tajamul Rashid ◽  
Farooq Ahmad Reshi ◽  
Iqbal Saleem Mir ◽  
Suhail Nazir Bhat ◽  
Irfan Nazir ◽  
...  

Background: Polypropylene mesh gives risk of recurrence, owing to overall decrease in the size of mesh and increased subjective foreign body feeling from contracture and scarring. An anatomically contoured 3D mesh for laparoscopic inguinal hernia repair often requires no fixation, with minimal risk of postoperative pain and recurrence rate.Methods: This was a prospective comparative study conducted over a period of 2.5 years. The study enrolled 60 patients, 30 patients in each group. The end points of the study were mesh fixation time, post-operative pain, seroma formation, hospital stay, chronic groin pain, sensory impairment, and cost and affordability. Follow up period was 18 months.Results: The mesh fixation time was less in 3D mesh, 10.6±4.31 minutes (p value- 0.0002). The incidence of severe immediate postoperative pain was higher in polypropylene mesh 10% (p value of 0.612). The postoperative seroma was less in 3D mesh, 3.3% (p value of 1.00). The mean hospital stay was shorter in 3D, 1.7±0.69 days (p value–0.005). Postoperative sensory impairment was more in polypropylene mesh, 6.6% (p value-1.00). The incidence of chronic groin pain was less in 3D (p value- 0.612). We found a higher recurrence rate at 18 months in both groups (p-value-1.00).Conclusions: The use of three-dimensional mesh for laparoscopic inguinal hernia repair is a safe and viable option. It offers many advantages in terms of less fixation time, shorter hospital stays, decreased chronic groin pain and morbidity. Elimination of tacks and shorter hospital stay may reduce the cost of 3D mesh.


2021 ◽  
Vol 8 (27) ◽  
pp. 2417-2422
Author(s):  
Sanjay Kala ◽  
Ramendra Kumar Jauhari ◽  
Anurag Singh ◽  
Abhishek V. Kulkarni

BACKGROUND The debate between fixation and non-fixation of mesh in laparoscopic hernia surgery has been going since the advent of this technique. While earlier studies insisted on mesh fixation, emerging studies are now supporting elimination of mesh fixation. Therefore, a prospective comparative study was performed in tertiary health care centre in northern India to compare the incidence of recurrence, post-operative pain and chronic groin pain between mesh fixation and non-fixation. In this study, we wanted to compare the intra-operative complications, post-operative pain and recovery, duration of hospital stay, incidence of chronic groin pain and pain during follow up visits and incidence of recurrence in laparoscopic inguinal hernia repair between fixation and non-fixation of mesh. METHODS A prospective comparative study was conducted among 50 patients admitted in surgery unit in a tertiary health care centre in northern India from January 2019 to October 2020 and were divided into two groups (group A - fixation, group B - non-fixation). Different factors such as post-operative pain, analgesia required post-operatively, duration of hospital stay, chronic groin pain and recurrence were compared between the two groups. Patients were followed up at 1, 3, 6 and 12 months. RESULTS The mean pain score at the end of 1 month and 3 months was higher in patients in the mesh fixation group. The days required by patients to resume their routine activities was lesser in patients in the non-fixation group. The recurrence rate was found to be similar in both the groups. CONCLUSIONS Mesh fixation offers no clear advantage over non-fixation and non-fixation can be considered as the preferred alternative as this procedure has less chance of postoperative pain, early ambulation and no increased risk of recurrence. KEYWORDS Laparoscopic Inguinal Hernia Repair, Mesh Fixation, Mesh Non-Fixation


VASA ◽  
2015 ◽  
Vol 44 (6) ◽  
pp. 451-457 ◽  
Author(s):  
Vincenzo Gasbarro ◽  
Luca Traina ◽  
Francesco Mascoli ◽  
Vincenzo Coscia ◽  
Gianluca Buffone ◽  
...  

Abstract. Background: Absorbable sutures are not generally accepted by most vascular surgeons for the fear of breakage of the suture line and the risk of aneurysmal formation, except in cases of paediatric surgery or in case of infections. Aim of this study is to provide evidence of safety and efficacy of the use of absorbable suture materials in carotid surgery. Patients and methods: In an 11 year period, 1126 patients (659 male [58.5 %], 467 female [41.5 %], median age 72) underwent carotid endarterectomy for carotid stenosis by either conventional with primary closure (cCEA) or eversion (eCEA) techniques. Patients were randomised into two groups according to the type of suture material used. In Group A, absorbable suture material (polyglycolic acid) was used and in Group B non-absorbable suture material (polypropylene) was used. Primary end-point was to compare severe restenosis and aneurysmal formation rates between the two groups of patients. For statistical analysis only cases with a minimum period of follow-up of 12 months were considered. Results: A total of 868 surgical procedures were considered for data analysis. Median follow-up was 6 years (range 1-10 years). The rate of postoperative complications was better for group A for both cCEA and eCEA procedures: 3.5 % and 2.0 % for group A, respectively, and 11.8 % and 12.9 % for group B, respectively. Conclusions: In carotid surgery, the use of absorbable suture material seems to be safe and effective and with a general lower complications rate compared to the use of non-absorbable materials.


2018 ◽  
Vol 84 (12) ◽  
pp. 1932-1937
Author(s):  
Anna-Maria ThÖLix ◽  
Jyrki Kössi ◽  
Veikko Remes ◽  
Tom Scheinin ◽  
Jukka Harju

Chronic groin pain after inguinal hernia mesh repair is a common problem. Mesh fixation without sutures has been suggested to have several advantages over the traditional suture fixation. The aim of this study was to compare two self-adhering meshes, the glued Adhesix® (AH) and the gripping Parietene ProGrip® (PP), and evaluate their impact on postoperative chronic pain and overall recovery. Two consultant surgeons performed altogether 393 open inguinal hernia operations at the Helsinki University Hospital during 2014 to 2015. The two groups, AH (n = 169) and PP (n = 224) were similar and comparable in terms of demographic data. The data were collected and analyzed from the patients’ medical records in the hospital's register. The patients were followed up for a period of 19 months (5-31 months). The number of patient contacts due to postoperative pain was significantly less common in the AH group than in the PP group, 4/169 (2.4%) versus 19/224 (8.5%) patients, respectively ( P = 0.011). The duration of pain was under three months for most patients, only two patients in the PP group had pain for over one year. The pain was treated most patients with anti-inflammatory painkillers, whereas injections of a local anesthetic and corticosteroid, and chronic pain medication was needed in some cases. It seems that the use of glue-coated mesh (Adhesix®) was associated with less postoperative visits due to pain compared with the self-fixating mesh with absorbable anchoring system (ProGrip®). Further studies with long-term follow-up are needed to confirm these results.


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