scholarly journals Audit of Patient Outcomes after Lichtenstein Hernioplasty for the Repair of Adult Inguinal Hernia

2019 ◽  
Vol 16 (2) ◽  
pp. 54-58
Author(s):  
Md Ibrahim Siddique ◽  
Samia Mubin ◽  
Krisna Rani Majumder ◽  
Muhammad Ali Siddiquee
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Mesh Repair ◽  
Groin Pain ◽  
General Surgeon ◽  
Chronic Groin Pain ◽  
Tension Free ◽  
Lichtenstein Hernioplasty

Background: Inguinal hernia repair is one of the most commonly performed surgeries worldwide. While numerous surgical approaches exist to treat inguinal hernias, the Lichtenstein tension-free mesh repair remains the gold standard. This retrospective study is carried out to evaluate the short and long term outcomes of Lichtenstein hernioplasty in the hand of a general surgeon. Patients and Methods: A retrospective analysis of all adult inguinal hernia repair by Lichtenstein method between January .2003 and December 2009 was carried out. The outcome measures were early post-operative complications, incidence of chronic groin pain and recurrence rate. Results: A total of 526 procedures were carried out in 445 adult male patients during the study period. The median age of the patients was 49 years (range, 21-73 years). All patients underwent Lichtenstein hernioplasty under spinal anesthesia. Length of hospital stay was median 2.4 days (range, 1-4 days). Median time to the resumption of normal activities was 8 days (range, 5-1 0 days). Urinary retention was the most frequent early post-operative complication (5.1 6%). Rate of wound infection was acceptable (0.44%). Chronic groin pain was experienced by three patients (0.67%). There was no recurrence observed among the 291 (65.4% of the total) patients who were available after two years of the procedure. Conclusion: The Lichtenstein open tension-free mesh repair of adult inguinal hernia is a safe procedure with least post-operative morbidity and least chance for recurrence. It is a simple technique, quick and. easy to perform without compromising the patient's care and long-term outcome in the hand of an experienced general surgeon. Journal of Surgical Sciences (2012) Vol. 16 (2) : 54-58

scholarly journals Local Anaesthetic Inguinal Hernia Repair Performed Under Supervision: Early and Long-Term Outcomes

2009 ◽  
Vol 91 (8) ◽  
pp. 677-680 ◽  
Author(s):  
P Sanjay ◽  
A Woodward
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Local Anaesthetic ◽  
Groin Pain ◽  
Postal Survey ◽  
Chronic Groin Pain ◽  
General Anaesthetic ◽  
Female Ratio

INTRODUCTION Local anaesthetic inguinal hernia repair may be technically demanding. There are minimal data regarding the outcomes of local anaesthetic hernia repair by trainees in comparison with consultants. PATIENTS AND METHODS All consecutive local anaesthetic repairs performed by trainees and one consultant over a 9-year period were reviewed. Operation time, volume of local anaesthetic used, early and long-term complications were assessed. A postal survey was conducted to assess chronic groin pain and satisfaction rates. RESULTS A total of 369 repairs were reviewed of which 265 repairs were performed by the consultant and 104 by trainees. The male-to-female ratio was 25:1 and the median age of the study group was 61 years (range, 18–93 years). The volume of local anaesthetic used was significantly higher for trainees than the consultant (42 ml versus 69 ml; P = 0.03). The operative time for the consultant and the trainees was 35 min and 40 min (P = 0.8). The day-case rate was higher for the consultant than the trainees (84% versus 69%; P = 0.02). Three patients operated by trainees required conversion to a general anaesthetic repair. No difference was noted in chronic groin pain (consultant 28% versus trainees 32%; P = 0.52) on the postal survey. The median follow-up was 5 years (range, 2–7 years). CONCLUSIONS Local anaesthetic inguinal hernia repair can be performed safely by surgical trainees under consultant supervision with minimal short- and long-term morbidity. A large volume dilute solution of Lignocaine and Marcaine is recommended when hernia repair is undertaken by trainees.

Outcome of tension free open mesh repair of inguinal hernia

2020 ◽  
Vol 22 (1) ◽  
pp. 21-24
Author(s):  
Mohammad Masum ◽  
Md Aminul Islam ◽  
Masflque Ahmed Bhuiyan ◽  
Kazi Mazharul Lslam ◽  
Md Selim Morshed ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Mesh Repair ◽  
Groin Hernia ◽  
Synthetic Mesh ◽  
Indirect Inguinal Hernia ◽  
Prolene Mesh ◽  
Tension Free ◽  
Open Mesh Repair

Background: In the practice of General Surgery, hernia repair is the second most common procedure after appendectomy. Several methods have been developed over the years to try to improve hernia repair. Good result can be expected using Bassini's, McVay's, Shouldice's techniques provided the exact nature of hernia is recognized and the repair is done without tension using healthy tissue. The introduction of synthetic mesh started a new era in hernia surgery. The use of synthetic mesh repair of primary and recurrent hernias has gradually gained acceptance among surgeons. Objective: To find out the outcome and complications of open inguinal hernia repair with prolene mesh. Methods: This is a prospective cross sectional study conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from December, 2011 to May, 2012. One hundred patients of inguinal hernia admitted in different surgical units of BSMMU, Dhaka for elective surgery were studied. We have given 1 gm ijv Cephradine per operatively and then 500 gm cephradine ijv 6 hourly for 24 hours followed by oral form of Cephradine for next 5 days. Polypropylene mesh of 11 cm x 7 cm size was used in all cases. All the operations were done by open tension free prolene mesh repair technique. Patients were followed for one year to see the outcome. Results: Out of 100 cases of inguinal hernia, 71 patients (71%) had indirect inguinal hernia and 29 cases (29%) had direct inguinal hernia; 90 cases (90%) were primary hernia and only 10 cases (10%) were recurrent hernia; 58 cases were right sided, 34 cases (34%) were left sided and 8 cases (8%) were bilateral. Complications of mesh repair of groin hernia in this study included wound infection (5%), scrotal oedema (2%), mesh infection (0%), scrotal hematoma (2%), echymoces of peri-incisional skin (5%), early wound and groin pain (7%), chronic inguinodynia (2%), hernia recurrence (1%). Conclusion: In the present study an attempt is made to evaluate the outcome of patients undergoing inguinal hernia repair by prolene mesh. The results confirm that Lichtenstein tension free mesh repair of inguinal hernia is safe and reliable for both primary and recurrent groin hernia, with less recurrence rate. Patient's compliance was good with minimum morbidity. Journal of Surgical Sciences (2018) Vol. 22 (1): 21-24

scholarly journals A comparative study of postoperative chronic pain after tension free inguinal hernia repair using absorbable versus non absorbable sutures for mesh fixation

2018 ◽  
Vol 5 (4) ◽  
pp. 1378 ◽  
Author(s):  
Laxmi Narayan Meena ◽  
Somendra Bansal ◽  
Pradeep Verma ◽  
Rohit Rai
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Groin Pain ◽  
Mesh Fixation ◽  
Absorbable Suture ◽  
Tension Free ◽  
Vas Score ◽  
Absorbable Sutures ◽  
Common Diagnosis

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.

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

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.

scholarly journals Prophylactic ilioinguinal neurectomy: Can it prevent chronic groin pain after Lichtenstein inguinal hernia repair?

2016 ◽  
Vol 4 (2) ◽  
pp. 39-44 ◽  
Author(s):  
Arbin Joshi
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Mesh Repair ◽  
Groin Pain ◽  
Chronic Groin Pain ◽  
Ilioinguinal Nerve ◽  
Nerve Preservation ◽  
Medical College ◽  
Open Mesh Repair

Background: Contrary to the previous belief, division of the ilioinguinal nerve prophylactically during mesh repair has been practiced to reduce the incidence and intensity of persistent postoperative pain after hernia repair. Objectives: To evaluate whether prophylactic ilioinguinal neurectomy prevents chronic groin pain after primary Lichtenstein hernia repair.Methods: Patients undergoing elective open mesh repair of inguinal hernia were randomized in two groups; nerve excision and nerve preservation group by opaque envelope method. Fifty cases were included in each group. A telephone interview was conducted after three months of the surgery. Pain scoring was done with Numeric Pain Intensity Scale and its effect in daily activities was measured with Patient Disability Index.Results: Forty-four patients in excision group and 45 in preservation group satisfied the inclusion criteria. Nine (20%) in the previous group and 16 (34.78%) in the latter group had chronic pain (p=0.113). Mean severity score in patients who had pain was significantly high in preservation group (2.22 versus 3.31, p=0.039). The incidence of scrotal numbness was higher in excision group (20% versus 13.3%, p=0.370).Conclusion: Though insignificant reduction in incidence of chronic groin pain was observed after division of ilioinguinal nerve, significant reduction in the intensity of the chronic pain especially during activities related to home and during self care has been shown.Journal of Kathmandu Medical College, Vol. 4, No. 2, Issue 12, Apr.-Jun., 2015, Page: 39-44

Sign in / Sign up

Export Citation Format

Share Document