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

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.

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

Journal of Current and Advance Medical Research ◽

10.3329/jcamr.v7i1.46430 ◽

2020 ◽

Vol 7 (1) ◽

pp. 44-48 ◽

Cited By ~ 1

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

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Evaluating effectiveness of cognitive behavioral therapy within multimodal treatment for chronic groin pain after inguinal hernia repair

Surgical Endoscopy ◽

10.1007/s00464-019-07082-5 ◽

2019 ◽

Vol 34 (7) ◽

pp. 3145-3152 ◽

Cited By ~ 1

Author(s):

Miles Landry ◽

Rachel Lewis ◽

Michael Lew ◽

Brandie Forman ◽

Eric Heidel ◽

...

Keyword(s):

Inguinal Hernia ◽

Cognitive Behavioral Therapy ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Multimodal Treatment ◽

Groin Pain ◽

Behavioral Therapy ◽

Cognitive Behavioral ◽

Chronic Groin Pain

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Desarda’s versus Lichtenstein technique of inguinal hernia repair

International Surgery Journal ◽

10.18203/2349-2902.isj20175553 ◽

2017 ◽

Vol 5 (1) ◽

pp. 92

Author(s):

Obaid Syed

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Hospital Stay ◽

Complication Rate ◽

Mesh Repair ◽

Post Operative Pain ◽

Significant Difference ◽

Duration Of Surgery ◽

Operative Complications ◽

The Mean

Background: Ideal method for modern hernia surgery should be simple, cost effective, safe, tension free and permanent. The Lichtenstein operation to a great extent achieves this entire goal. The Lichtenstein mesh repair is associated with complications, postoperative dysfunction and high cost composite meshes. Desarda's technique, became a new surgical option for tissue-based inguinal hernia repair. The present study was designed to evaluate and compare the effectiveness and complications of the Desarda’s repair with Lichtenstein tension-free mesh repair for treatment of inguinal hernia in a developing country.Methods: 200 patients with unilateral, primary, reducible inguinal hernia were selected. Included patients were randomly divided into two groups. Studied parameters were Duration of surgery, intra operative complications, post-operative Pain, Duration of hospital stay, return to normal activities, post-operative complications and recurrences.Results: There were a total of 100 patients each group. There was no statistically significant difference in duration of surgery and complication rate between the two groups. Difference in mean VAS was not statistically significant. The mean hospital stay in Desarda’s technique was 2.5 days while it was 2.6 days in Lichtenstein’s group. The mean time to return to basic physical activity in the Desarda’s technique was 12.6 days while it was 13.3 days in the Lichtenstein’s group. There were no recurrences in either group. Chronic inguinal pain (>1month) was more frequent in Lichtenstein’s group.Conclusions: There is no significant difference in duration of surgery, intra operative complication rate, post-operative pain, complications and recurrence, between Desarda’s technique and Lichtenstein’s technique. However chronic inguinal pain is less in Desarda’s technique. Desarda’s repair must be considered in young patients (<30 years). Its long-term efficacy needs to be studied with larger, prospective double-blind randomized trials, with longer follow-up.

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

International Surgery Journal ◽

10.18203/2349-2902.isj20210925 ◽

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.

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Using inferior epigastric vascular anatomical landmarks for anterior inguinal hernia repair

BMC Surgery ◽

10.1186/s12893-019-0627-0 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Weiming Li ◽

Yijun Li ◽

Lili Ding ◽

Xiongzhi Chen ◽

Qingwen Xu ◽

...

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Hospital Stay ◽

Inguinal Hernia Repair ◽

Foreign Bodies ◽

Length Of Hospital Stay ◽

Operation Time ◽

Complication Rates ◽

Anatomical Landmarks ◽

Post Operative Pain

Abstract Background Inferior epigastric vascular anatomical landmarks for anterior inguinal hernia repair is an alternative surgical procedure. We present our experience and outcome of the way. Methods We performed a retrospective analysis of 230 patients who received anterior tension-free hernia repair between May 2016 to May 2017. Among these cases, 120 were performed using the traditional transinguinal preperitoneal (TTIPP) technique while 100 were performed using the vascular anatomic landmark transinguinal preperitoneal (VALTIPP) technique. Between these two groups, we compared the operation time, length of hospital stay, complication rates, and the visual analog scale (VAS) for pain at 2 days, 3 months, and 6 months after surgery. Results Surgery was well-tolerated in both groups with no significant hemorrhage or complications. The operation times for the VALTIPP and TTIPP groups were 42.52 ± 9.15 and 53.84 ± 10.64 min (P < 0.05), respectively. Ten patients in the VALTIPP group and 17 patients in the TTIPP group reported sensations of foreign bodies (P < 0.05). The VAS pain score in VALTIPP patients at 2 days (4.0 ± 0.5), 3 months (1.0 ± 0.3), and 6 months (0.9 ± 0.3) were significantly lower when compared with those of TTIPP patients (5.3 ± 0.9 at 2 days, 1.8 ± 0.4 at 3 months, and 1.1 ± 0.1 at 6 months, p < 0.05). No statistically significant differences were found in age, gender, BMI, hernia type and location, follow-up period, incidence of post-operative seromas, recurrence rate, or length of hospital stay. Conclusion Anterior inguinal hernia repair using inferior epigastric vascular anatomical landmarks may lead to reduced operation times, reduced sensations of foreign bodies, and reduced post-operative pain. This technique is simple, practical, and effective in the management of inguinal hernias.

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TP7.2.12 Robotic versus laparoscopic inguinal hernia repair: a systematic review

British Journal of Surgery ◽

10.1093/bjs/znab362.058 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Anja Imsirovic ◽

Rahul Bagga ◽

Mansoor Khan ◽

Krishna Singh ◽

Parv Sains ◽

...

Keyword(s):

Systematic Review ◽

Inguinal Hernia ◽

Hernia Repair ◽

Pain Score ◽

Inguinal Hernia Repair ◽

Surgical Outcomes ◽

Comparative Studies ◽

Groin Pain ◽

Chronic Groin Pain ◽

Duration Of Operation

Abstract Aims Robotic inguinal hernia repair (RIHR) is considered to improve surgical outcomes in patients undergoing inguinal hernia surgery. The objective is to present a systematic review of RIHR compared to laparoscopic repair (LIHR). Methods A systematic review of comparative studies until January 2021 published on Embase, Medline, PubMed, PubMed Central and Cochrane databases reporting the surgical outcomes in patients undergoing RIHR versus LIHR was performed. Results A total of 12565 patients in 10 comparative studies were included. In the random effects model analysis using the statistical software Review Manager, statistically the RIHR prolonged the duration of operation (Standardized mean difference (SMD), 3.33; z = 5.84; P = 0.00001) but the length of stay (SMD, -0.8; z = 0.66; P = 0.51) and post-operative pain score (SMD, -0.47; z = 1.19; P = 0.24) were similar in both groups. In addition, the recurrence rate was similar in both groups (p = 0.92). The incidence of post-operative complications (OR 1.67; 95% CI, 1.14, 2.45; z = 2.64; P = 0.008) and chronic groin pain (OR 2.14; 95% CI, 0.97, 4.72; z = 1.88; P = 0.06) was higher in RIHR group. Conclusion RIHR is feasible and safe, but the duration of operation is significantly longer with equivocal other variables such as stay and pain score. There was higher incidence of post-operative morbidity and chronic groin pain as well. Major multi-center randomized controlled trial is mandatory to assess the long terms outcomes and cost effectiveness before the routine use of RIHR.

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