scholarly journals Analysis of Acute Postoperative Pain in Patients undergoing Transabdominal Preperitoneal (TAPP) Repair of Inguinal Hernia in Manipal Teaching Hospital

2020 ◽  
Vol 5 (1) ◽  
pp. 71-78
Author(s):  
Binod Bade Shrestha ◽  
Sujan Shrestha

 Background: Laparoscopic inguinal hernia repair in adults require the use of prosthetic material. We aimed to investigate the acute postoperative pain in patients who underwent transabdominal preperitoneal inguinal hernia repair using heavy or light weight polypropylene mesh. Methods: This observational, analytical study was conducted in172 adult patients, aged 18-80 years, who underwent transabdominal preperitoneal inguinal hernia repair from January 2017 - October 2019. The patients were divided into two groups as HWM group (heavyweight polypropylene mesh), n=81 and LWM group (light weight polypropylene mesh) n=91. The patients in both the groups were compared in terms of acute postoperative pain at 24 and 48 hours using visual analogue scale (VAS) score. Results: The visual analogue scale (VAS) score of HWM group and LWM group at 24 hours was 5.42 ± 1.25 and 4.46 ± 1.61 respectively (p=0.00). The VAS score at 48 hours was 3.44 ± 1.07 and 2.74 ± 1.27 for HWM and LWM group respectively (p=0.00).  Conclusions: The post-operative pain at 24 and 48 hours following transabdominal preperitoneal inguinal hernia repair using light weight polypropylene mesh was less as compared to the patients whose hernia were repaired using heavy weight polypropylene mesh.

2019 ◽  
Vol 109 (4) ◽  
pp. 289-294
Author(s):  
N. Johansen ◽  
C. D. Vyrdal ◽  
T. Bisgaard

Background: Majority of studies on chronic postoperative inguinal pain has described the occurrence after unilateral inguinal hernia repair. Endo-laparoscopic repair, for example, laparoscopic transabdominal preperitoneal inguinal hernia repair, has been recommended for primary bilateral symptomatic inguinal hernias, although the literature on chronic postoperative inguinal pain among this type of patients is limited. The present study analyzed chronic postoperative inguinal pain following bilateral transabdominal preperitoneal inguinal hernia repair. Methods: Nationwide consecutive patients who underwent bilateral transabdominal preperitoneal inguinal hernia repair (July 2012–June 2013) were recruited from the Danish Inguinal Hernia Database and cross-checked with hospital files and the National Patient Registry. A prospective follow-up was performed with a standardized postal questionnaire including questions on functional performance status assessed by a modified version of the Activity Assessment Scale. The primary outcome was incidence of chronic postoperative inguinal pain defined as moderate to severe pain-related impairment of everyday activities. Pain was registered according to the two individual groin areas. Furthermore, the overall incidence of chronic postoperative inguinal pain per operated inguinal hernia was calculated. Intensity of experienced pain (Activity Assessment Scale score) was compared between patients reporting pain from one versus both groin areas. Results: In total, 209 patients (418 hernia repairs) were analyzed (questionnaire response rate 83%). The median follow-up time was 27 months (22–34 months). In total, 27 of 209 patients (13%) complained of chronic postoperative inguinal pain from either one ( n = 17) or both ( n = 10) groin areas after bilateral transabdominal preperitoneal inguinal hernia repair. The incidence of chronic inguinal pain per operated hernia was 9%. The intensity of impairment due to pain (Activity Assessment Scale score) did not differ significantly between patients with chronic postoperative inguinal pain in one (19%) versus both sides (30%), p = 0.056. Conclusion: Bilateral transabdominal preperitoneal inguinal hernia repair for symptomatic inguinal hernias was related to a high incidence (13%) of chronic postoperative inguinal pain and decreased functional performance status.


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