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.

scholarly journals Comparative study of preservation versus elective division of ilioinguinal nerve on chronic groin pain after lichtenstein tension free inguinal hernia repair

2020 ◽  
Vol 7 (5) ◽  
pp. 1503
Author(s):  
Renuka Chaudhary ◽  
M. Salim ◽  
M. Rafik Rao
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Groin Pain ◽  
Chronic Groin Pain ◽  
Ilioinguinal Nerve ◽  
Nerve Preservation ◽  
Group A ◽  
Group B

Background: Post-hernioplasty chronic groin pain is one of the most important complications encountered after inguinal hernia repair. Routine ilioinguinal nerve excision has been proposed to avoid chronic post-hernioplasty neuralgia. The study aimed to evaluate the effect of routine ilioinguinal nerve excision compared to nerve preservation on chronic groin pain and other sensory symptoms in lichtenstein inguinal hernia repair.Methods: The study was conducted in the department of general surgery, at S.P. Medical College and PBM Hospital, Bikaner for duration of 15 months from august 2018 to November 2019. A total of 60 patients of uncomplicated inguinal hernia, who met the inclusion criteria, planned for lichtenstein hernioplasty were randomly divided into 2 groups with 30 cases with ilioinguinal nerve preservation (group A) and 30 cases with elective division of the nerve (group B). Follow up was done upto1 year and patients were inquired regarding pain, hypoesthesia and numbness and data was compared and analysed.Results: The incidence of post-operative neuralgia was 23.33% vs 6.67% (p=0.05) at 1 year in group A and group B respectively. The difference in pain was significant in both groups. The incidence of post-operative hypoesthesia was 10% vs 16.67% (p>0.05) at 1 year follow up in group A and group B respectively. The incidence of numbness was 11.11% vs 16.67% (p>0.05) at 1 year in group A and group B respectively. No statistically significant difference was found in both groups.Conclusions: The prophylactic exicision of ilioinguinal nerve during lichtenstein mesh repair decreases the incidence of chronic groin pain after surgery.

scholarly journals Post-Operative Outcome of Desarda Repair of Inguinal Hernia in Emergency Case in Bangladesh

2020 ◽  
Vol 7 (1) ◽  
pp. 44-48 ◽  
Author(s):  
SM Iftekhar Uddeen Sagar ◽  
SM Nazrul Islam ◽  
Md Abul Kalam Azad ◽  
Mohammad Khaleduzzaman Khan ◽  
Muhammad Mofazzal Hossain ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Groin Pain ◽  
Operating Time ◽  
Early Recurrence ◽  
Chronic Groin Pain ◽  
Post Operative Pain ◽  
Operative Complications ◽  
Post Operative Complications

Background: Desarda hernia repair has emerged as a recognized operative method for inguinal hernia repair. Objective: The purpose of the present study was to see the outcome of emergency inguinal hernia repair by Desarda technique. Methodology: This was an observational study was carried out in the Department of Surgery at Sher-E-Bangla Medical College Hospital, Barisal, Bangladesh and Private Hospital, Narayanganj, Bangladesh from August 2015 to January 2017. Twenty patient was operated by Desarda technique. Variables includes age, operating time, post-operative complications, post-operative hospital stay, cost of the procedure, chronic groin pain and any early recurrence. Result: Mean age of patient 50.25±18.9, Mean operating time was 78.4±9.64 mins. Majority 16 patient experienced mild post-operative pain measured in VAS score. Mean with SD of hospital stay was 5.05±2.16 days. Patient had developed different post-operative complications like wound infection in 2(10.0%) cases, scrotal edema in 5(25.0%) cases, seroma formation in 1(5.0%) case and no early recurrence and. Conclusion: In this study, it revealed that Desarda repair was associated with less post-operative complications, less post-operative pain, zero recurrence rate, no chronic groin pain and performed in emergency cases. So it is safe and most reliable technique for complicated (Incarcerated, Obstructed, Strangulated) inguinal hernia. Journal of Current and Advance Medical Research 2020;7(1): 44-48

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 Repair of inguinal hernia by Desarda technique in both elective and emergency setting

2019 ◽  
Vol 45 (3) ◽  
pp. 180-184
Author(s):  
S.M. Iftekhar Uddeen Sagar ◽  
Muhammad Syeef Khalid ◽  
Abu Sayeed Md. Feroz Mustafa ◽  
SM Nazrul Islam
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Inguinal Hernia Repair ◽  
Groin Pain ◽  
Operating Time ◽  
Chronic Groin Pain ◽  
Post Operative Pain ◽  
Operative Complications ◽  
Post Operative Complications

Background: Inguinal hernia is a common problem and its repair is one of the most commonly performed procedures in general surgical practice. Several methods have been developed including Lichtenstein’s repair. Among these Lichtenstein’s repair has been standard technique for last few decades. In recent time a new procedure “no mesh Desarda hernia repair” has emerged as a recognized operative method for inguinal hernia repair. Objectives: This study was conducted to evaluate the outcome of Desarda technique in repairing inguinal hernia. Methods: This was a single centered descriptive study to see the outcome of inguinal hernia repair by Desarda technique in both elective and emergency surgery carried out in the Dept. of Surgery, Sher-E-Bangla Medical College Hospital, Barisal from August, 2015 to July, 2016. Results: A total of 100 patients underwent Desarda repair for inguinal hernia including primary/recurrent and elective/ emergency cases. Variables includes age, type of surgery, operating time, post-operative complications, post-operative pain, post-operative hospital stay, cost of the procedure, chronic groin pain and any early recurrence. Mean age of patient was 48.9±9.07 years. Mean operating time was 43.72±9.64mins. Majority (54%) of the patient experienced mild post-operative pain on first day, measured in VAS score. Ten percent of patients developed different post-operative complications like wound infection (2%), seroma formation (1%) and scrotaledema (7%). Conclusion: In this study, it is revealed that no mesh Desarda repair for inguinal hernia was associated with less operating time, less post-operative pain, less post-operative complications, short hospital stay, zero recurrence rate, no chronic groin pain and performed in emergency cases also. So, it is safe and most reliable technique for all type of inguinal hernia surgery.

scholarly journals A prospective comparative study of Lichtenstein procedure with and without mesh-fixation for inguinal hernia repair

2021 ◽  
Vol 9 (2) ◽  
pp. 390
Author(s):  
Ravinder Kumar ◽  
Hilal A. Wani ◽  
Anshuman Mahesh ◽  
Irfan N. Mir
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Operative Time ◽  
Mesh Fixation ◽  
P Value ◽  
Recurrence Rates ◽  
Fixation Group ◽  
Post Operative Pain ◽  
Group A ◽  
Group B

Background: Repair of inguinal hernia is one of the most common elective operations performed in general surgery worldwide. Mesh-hernioplasty became the gold standard, because of its low recurrence rate in comparison with tissue repairs. The ideal repair must be simple, safe easy to perform and require minimal dissection which provides enough space, should be cost effective with less hospital stay, less pain and less recurrence. The present study aimed at comparing the effect of mesh fixation and non-fixation in Lichtenstein technique for inguinal hernia repair.Methods: Hundred (100) patients with primary uncomplicated, unilateral inguinal hernia were treated between April 2019 and September 2020. Patients with inguinal hernia underwent Lichtenstein repair with mesh-fixation (group A) (n=50) and non-fixation (group B) (n=50). The mean operative time, post-operative pain score, average hospital study, post-operative complications and recurrence rates were compared between the two groups.Results: Mean operative time in non-fixation group- (group B) (32.24 min) was shorter as compared to fixation group-(G1) (49.36 min) with a p value of 0.002. Post-operative pain score was lower in (group B) at 12 and 24 hours (3.71±1.409 and 2.2±0.8169) as compared to G1 at 12 and 24 hours (4.77±1.196 and 2.98±1.295) with a p value of <0.0001. The analgesia required in (group B) was less as compared to (group A). The post-operative complication and recurrence rates were almost identical in both the groups, with lesser incidence of groin pain and paresthesias in group B.Conclusions: In Lichtenstein inguinal hernia repair, non-fixation of mesh is safe and preferable option, with less operative time and less postoperative pain.

scholarly journals Desarda’s versus Lichtenstein technique of inguinal hernia repair: a comparative study

2019 ◽  
Vol 6 (10) ◽  
pp. 3719
Author(s):  
Mohammad Sadik Akhtar ◽  
Suraj Kant Mani ◽  
Yasir Alvi ◽  
Parveg Alam ◽  
Syed Amzad Ali Rizvi ◽  
...  
Keyword(s):  
Physical Activity ◽  
Inguinal Hernia ◽  
Foreign Body ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Groin Pain ◽  
Foreign Body Sensation ◽  
Chronic Groin Pain ◽  
Body Sensation

Background: Inguinal hernias rank among the commonest of all hernias and surgery is the only definitive treatment. We analyzed the outcomes of desarda tissue based repair in comparison with the standard Lichtenstein tension free mesh repair of primary inguinal hernia.Methods: A total of 164 patients were randomly allocated into two groups, Desarda (group D) or Lichtenstein (group L) (80 VS 84, respectively). The primary outcome measures were chronic groin pain and recurrence during the follow up period. Secondary outcome measures included operating time, post-operative pain scores, duration of post-operative hospital stay, time to return to basic physical activity and to work, foreign body sensation, and post-operative complications.Results: During two year follow up, no recurrence was detected in each group. Operative time was significantly less in the Desarda group (28.91±5.82 min as compared to 34.07±8.63 min in the Lichtenstein group). Postoperative day 1, day 3 and day 7 groin pain was more in the Desarda as compared to the Lichtenstein group. Basic physical activity, chronic groin pain, cost, seroma formation, foreign body sensation, were also significantly less in the Desarda group.Conclusions: The successful primary inguinal hernia repair without mesh implantation can be achieved using Desarda tissue based repair, as it is effective as the standard Lichtenstein tension free mesh repair. Shorter operative time, early return to basic physical activity, lower cost, less chronic groin pain, less foreign body sensation are potential benefits of Desarda repair and can be preferred for inguinal hernia repair.

A Prospective Comparative Study in Laparoscopic Inguinal Hernia Repair with Regard to Fixation and Non-Fixation of Mesh in a Tertiary Care Centre in Northern India

2021 ◽  
Vol 8 (27) ◽  
pp. 2417-2422
Author(s):  
Sanjay Kala ◽  
Ramendra Kumar Jauhari ◽  
Anurag Singh ◽  
Abhishek V. Kulkarni
Keyword(s):  
Inguinal Hernia ◽  
Groin Pain ◽  
Mesh Fixation ◽  
Laparoscopic Inguinal Hernia Repair ◽  
Chronic Groin Pain ◽  
Care Centre ◽  
Northern India ◽  
Laparoscopic Inguinal Hernia ◽  
Post Operative Pain ◽  
Prospective Comparative Study

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

scholarly journals Outcomes on mesh fixation vs non-fixation in laparoscopic totally extra peritoneal inguinal hernia repair: a comparative study

2021 ◽  
Vol 37 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Abu Kamal Nahid ◽  
Sanjida Rahman ◽  
Keerthanaa Veerapatherar ◽  
Roland Fernandes
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Comparative Study ◽  
Inguinal Hernia Repair ◽  
Mesh Fixation ◽  
Clinical Effects ◽  
Open Approach ◽  
Post Operative Pain ◽  
Group A ◽  
Group B

Objective: Inguinal hernia repair is one of the most common general surgical procedure, and laparoscopic approach gained popularity over the open approach. This study aimed to compare the clinical effects of TEP inguinal hernioplasty with or without mesh fixation. The primary outcome was acute post-operative pain. Material and Methods: A retrospective comparative study on a prospectively collected data was conducted in a large DGH in England between Janu- ary 2017 and December 2019 on 47 patients. The patients were divided into two groups. In group A, mesh fixation was performed with absorbable tackers and in group B no fixation was performed. Patients were followed up to 18 months postoperatively. Data was collected on post-operative pain, cost, recurrences and time taken to return to normal activities. Patients with lower midline scar and complicated inguinal hernias were excluded. Results: Out of the 47 patients 53% (n= 25) were in group A and 47% (n= 22) in group B. All the patients in both groups were male. The mean postopera- tive pain score at 72h in group A was 7.12 (SD 1.13) and 4.91 (SD 1.23) in group B (p< 0.001). Group B patients have taken shorter time to return to normal activities in comparison to group A (p< 0.001), while recurrence (2%) rate is higher in group B (p> 0.05). Conclusion: Pain and time taken to return to normal work postoperatively were significantly less in the non-fixation group. The study recommends non-fixation over fixation as it is feasible, cost-effective, causes less post-operative pain and no differences in terms of recurrences.

scholarly journals Status of self-medication among the patients attending outpatient department in selected private hospitals in Dhaka city

2019 ◽  
Vol 45 (3) ◽  
pp. 185-190
Author(s):  
Md. Riyadh Hasan ◽  
Nawzia Yasmin ◽  
Nuhad Raisa Seoty ◽  
Md. Maniul Hasan ◽  
Maj. Gen. (Retd) Dr. M Shahjahan
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Inguinal Hernia Repair ◽  
Groin Pain ◽  
Operating Time ◽  
Chronic Groin Pain ◽  
Post Operative Pain ◽  
Operative Complications ◽  
Post Operative Complications

Background: Inguinal hernia is a common problem and its repair is one of the most commonly performed procedures in general surgical practice. Several methods have been developed including Lichtenstein’s repair. Among these Lichtenstein’s repair has been standard technique for last few decades. In recent time a new procedure “no mesh Desarda hernia repair” has emerged as a recognized operative method for inguinal hernia repair. Objectives: This study was conducted to evaluate the outcome of Desarda technique in repairing inguinal hernia. Methods: This was a single centered descriptive study to see the outcome of inguinal hernia repair by Desarda technique in both elective and emergency surgery carried out in the Dept. of Surgery, Sher-E-Bangla Medical College Hospital, Barisal from August, 2015 to July, 2016. Results: A total of 100 patients underwent Desarda repair for inguinal hernia including primary/recurrent and elective/ emergency cases. Variables includes age, type of surgery, operating time, post-operative complications, post-operative pain, post-operative hospital stay, cost of the procedure, chronic groin pain and any early recurrence. Mean age of patient was 48.9±9.07 years. Mean operating time was 43.72±9.64mins. Majority (54%) of the patient experienced mild post-operative pain on first day, measured in VAS score. Ten percent of patients developed different post-operative complications like wound infection (2%), seroma formation (1%) and scrotaledema (7%). Conclusion: In this study, it is revealed that no mesh Desarda repair for inguinal hernia was associated with less operating time, less post-operative pain, less post-operative complications, short hospital stay, zero recurrence rate, no chronic groin pain and performed in emergency cases also. So, it is safe and most reliable technique for all type of inguinal hernia surgery.

scholarly journals Suture mesh fixation versus glue mesh fixation in open Lichtenstein inguinal hernia repair

2021 ◽  
Vol 8 (3) ◽  
pp. 863
Author(s):  
D. K. Shah ◽  
Kamlesh Soni ◽  
Manish Bariya ◽  
Tejas Vagh
Keyword(s):  
Groin Pain ◽  
Operative Time ◽  
Mesh Fixation ◽  
P Value ◽  
Chronic Groin Pain ◽  
Time Duration ◽  
Randomized Controlled ◽  
Post Operative Pain ◽  
Group A ◽  
Group B

Background: This randomized controlled trials was conducted for systematic comparison of suture mesh fixation (SMF) versus glue mesh fixation (GMF) in open inguinal hernia repair with regards to chronic groin pain, recurrence, operative time, post operative pain and postoperative complications.Methods: This study was a single-center, prospective randomized, controlled trial of two groups. It compared post-operative outcomes of mesh fixation with suture (Group A) versus glue (Group B). It was done at Baroda Medical College and S.S.G. Hospital, from May 2018 to January 2019 for case study, intervention and followed up for 9 months till October 2019.Results: Intra operative time duration for mesh fixation is less in Group B (glue mesh fixation) as compare with Group A (suture mesh fixation) with the statistically significant p value of 0.003. Post-operative pain score (mean VAS score) is significantly less in group B. Mean VAS in group A was 1.27 at 3 month while in group B was 1.06 with the p value of 0.048 on 3 month, which is statistically significant. It suggests that chronic groin pain (pain at or after 3 month) significantly less in group B as compared with group A.Conclusions: Mesh fixation by glue has advantage of less intra operative time duration and less post-operative pain and chronic groin pain as compare to mesh fixation by suture.

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