Postoperative Pain in Laparoscopic Transabdominal Preperitoneal Versus Lichtenstein Open Mesh Repair Techniques for Inguinal Hernia

Background: Postoperative pain after open mesh repair of inguinal hernia is an important challenge. Such type of pain sometimes does not respond to medical treatment including non-steroidal anti-inflammatory drugs and opiates. The objective of the present study was to evaluate the effect of preservation or division of the Ilioinguinal nerve on pain and post-operative symptoms, after open mesh repair of inguinal hernia.Methods: All patients undergoing surgery for tension free Lichtenstein mesh repair over a period of 1 year were included. Patients below the age of 18 years and patients with bilateral or recurrent hernias were excluded.Results: In present study of 42 patients, early mean postoperative pain at day 1 was 1.8 on VAS scale in ilioinguinal neurectomised patient compared to 1.5 in nerve preserved group (P=0.1408). Postoperative pain at week 1 was 1.25 in neurectomised patients compared to 1.32 in nerve preserved group (P=0.7161). Late Postoperative pain and chronic groin pain was 0.6 and 0.25 at 1 and 3 months respectively in ilioinguinal neurectomised patients as compared to 1.05 and 0.77 at 1 and 3 months respectively in nerve preserved group (P=0.0184 at 1month and P=0.0335 at 3 months).Conclusions: The difference in postoperative pain at day 1 and at week 1 was not significant and both groups had equal pain. Late postoperative pain (at 1 month) and chronic groin pain (at 3 months) was significantly low in ilioinguinal neurectomised patient compared to nerve preserved group.

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Rare giant inguinal hernia causing end-stage dialysis-dependent renal failure

BMJ Case Reports ◽

10.1136/bcr-2019-233140 ◽

2020 ◽

Vol 13 (4) ◽

pp. e233140

Author(s):

Jacob Levi ◽

Karl Chopra ◽

Mubashar Hussain ◽

Shafiul Chowdhury

Keyword(s):

Inguinal Hernia ◽

Mesh Repair ◽

Obstructive Uropathy ◽

Kidney Injury ◽

Past Medical History ◽

Bladder Hernia ◽

Open Mesh Repair ◽

Catheter Tip ◽

End Stage ◽

Open Mesh

A 72-year-old man presented with urinary retention, weight loss, haematuria and severe acute kidney injury. He had never before been admitted to hospital and his past medical history included only an inguinal hernia. On examination, he appeared uraemic and had a right-sided painful hernia. A three-way catheter was inserted, bladder washouts performed and irrigation started. An ultrasound showed severe bilateral hydronephrosis and a ‘thickened bladder’ and this was thought to be obstructive uropathy secondary to bladder cancer. Twenty-four hours later his hernia doubled in diameter, became incarcerated and a CT of the abdomen and pelvis showed an inguinal hernia of both bladder and bowel, with the catheter tip inside the bladder hernia. He was taken to theatres and an open mesh repair was performed with a rigid cystoscopy to assist in locating and reducing the bladder. He required intensive care and dialysis postoperatively and remains on regular dialysis following discharge.

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Authors' reply: Meta-analysis of randomized controlled trials comparing laparoscopic with open mesh repair of recurrent inguinal hernia (Br J Surg 2010; 97: 4-11)

British Journal of Surgery ◽

10.1002/bjs.7063 ◽

2010 ◽

Vol 97 (4) ◽

pp. 621-622 ◽

Cited By ~ 3

Author(s):

A. Karthikesalingam ◽

S. Markar ◽

P. Holt ◽

R. Praseedom

Keyword(s):

Inguinal Hernia ◽

Randomized Controlled Trials ◽

Mesh Repair ◽

Meta Analysis ◽

Recurrent Inguinal Hernia ◽

Controlled Trials ◽

Randomized Controlled ◽

Open Mesh Repair ◽

Open Mesh

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Comparative study of open mesh repair and Desarda’s no-mesh repair for inguinal hernia, in GMKMCH, Salem, India

International Surgery Journal ◽

10.18203/2349-2902.isj20183737 ◽

2018 ◽

Vol 5 (9) ◽

pp. 3139

Author(s):

Prakash . ◽

Padmalakshmi Bharathi Mohan

Keyword(s):

Inguinal Hernia ◽

Mesh Repair ◽

Surgical Site Infections ◽

Wall Stiffness ◽

Open Mesh Repair ◽

Scrotal Edema ◽

Background Mesh ◽

Surgical Field ◽

Repair Techniques

Background: Mesh repair has gained popularity among the surgical repair of hernias but has limitations. This study is being carried out to compare the effectiveness of Desarda’s no mesh repair, with Lichtenstein’s tension free repair.Methods: This prospective study was carried out in GMKMCH, Salem, over a period of 2 years. A total of 60 cases with inguinal hernia were included in the study. 30 patients were randomly subjected to Desarda’s technique and 30 patients underwent Lichtenstein’s repair. After surgery, patients were followed up and noted for complications like groin pain, surgical site infections, duration of hospital stay, duration to return to normal activity.Results: Operative time was 45 minutes in Desarda’s group and 50 minutes in the Lichtenstein group which was highly significant (p<0.01). On 2-year follow-up there were no recurrences in both groups. There were no surgical site infections in the Desarda’s group, compared to whereas Lichtenstein’s repair where had 4 (10%) recurrences. The occurrence of complications like loss of sensation over the groin, scrotal edema, abdominal wall stiffness was not seen in Desarda’s group, whereas its occurrence was highly significant (p<.01) in Lichtenstein’s group.Conclusions: Desarda’s no mesh technique is easy to learn and simple when compared to other no mesh repair techniques and requires no mesh. It can be used in a contaminated surgical field, in young individuals and in cases of financial constraints. Hence, Desarda’s no mesh repair is favourably comparable with Lichtenstein’s mesh repair.

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