Open Maloney Repair for Adult Inguinal Hernia, 5 Years Experience in A Remote District

Background: In a remote district city of Bangladesh, inguinal hernias were repaired by Maloney (Darning) method.Efficacy of Darning repair was compared in this study.Aims and Objectives: The aim of this study was to determine the feasibility of doing Maloney ( Darn ) repair for adult inguinal hernias by specialist surgeons at remote districts . Age of the patients in ourstudy were above 20 years.Study Design: A descriptive retrospective study.Materials and Methods:In our study we included 2000 patient of inguinal hernia surgery repairs from May 2012 through June 2017. In the patients of the study group we repaired inguinal hernia by Maloney ( Darning) technique. Number of patients were 2000 ( male 1990 [99.5%] female 10 [.5%] with a mean age of 45.7 years. There were 1002(50.1%) hernias on the right side, 890(44.5%) were on the left side and 108(5.4%) were bilateral. Among the hernias 1419 ( 70.9%) were indirect, 575 (28.7%) were direct and 4 (0.2%) were of both direct and indirect (Pantoolon type), 2 (0.1%) were of femoral hernia. All were of primary hernias, recurrent hernias and hernias in patients with apparently weak musculature were repaired by Lychtenistein method with prolein mesh and were not included in this stpudy. 60 (3%) patients had feature of incarceration and 20 (1%) patients presented with obstruction. Among the obstructed hernias 8 (.4%) had strangulation and in 2 (.1%) resection and anastomosis were required for gangrenous ileum. In rest of the cases of strangulation circulation returned after incising the constricting ring and hot mob compression. We used IV antibiotic for 24 hours stated with induction of anaesthesia followed by oral for next 6 days. We used Injection Ceftrixone followed by Cefixime and in some patients Flucloxacillin.Statistics Analysis Used: Simple frequencies, proportion and cross tabulation.Results: Average duration of surgery was 70 minutes. There was no perioperative mortality. 90 (4.5%) patients developed mild subcutaneous wound infection, haematoma occurred in 160 ( 8% ) patients and seroma found in 300 ( 15% ) patients. All haematoma and seroma subsided gradually. Only 1 patient needed secondary closure for infected wound gap. The average duration of hospitalization was 3 days. All patients in study group are still in contact with me. Three patients (0.15%) had recurrences. All the recurrent cases reported within 6 months of their operations. Among the three age of 2 patients was above 60 and one patient of age above 70 had Maloney hernia repair for obstructed hernia.Conclusion:In remote places where prolene mesh is not available or is costly we can repair inguinal hernia by Maloney operation with very simple antibiotics with good results in comparison with other methods.J Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 6-10

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Postoperative condition of patients as a result of treatment of inguinal hernias by laparoscopic and open methods

Paediatric Surgery Ukraine ◽

10.15574/ps.2021.72.30 ◽

2021 ◽

pp. 30-35

Author(s):

V.V. Skyba ◽

◽

A.V. Ivanko ◽

N.V. Voytyuk ◽

V.V. Lysytsia ◽

...

Keyword(s):

Inguinal Hernia ◽

Surgical Treatment ◽

Open Access ◽

Hospital Stay ◽

Laparoscopic Approach ◽

Length Of Hospital Stay ◽

Lower Percentage ◽

Hernia Surgery ◽

Inguinal Hernias ◽

Inguinal Hernia Surgery

Purpose – to analyze condition of patients after surgical treatment of inguinal hernias by laparoscopic and open methods. Materials and methods. A retrospective review of medical histories and outpatient charts of all patients who underwent inguinal hernia surgery at the Kyiv City Clinical Hospital No. 1 from January 2018 to July 2020 was conducted. Results. During the above period of time in our hospital open hernioplasty was performed in 86 patients, laparoscopic hernioplasty – 138 patients. With open hernioplasty, the average duration of surgical treatment was 40±12 minutes. The laparoscopic technique was 35±12 minutes. The length of hospital stay was significantly longer in the group of patients with the open method (48±12 hours) than in the group of laparoscopic plastic surgery (12±3 hours). From the group of patients who underwent open hernioplasty, 62 patients complained of long-term pain syndrome, from the group of laparoscopy – 12 patients. The cosmetic appearance was dissatisfied with 34 patients in the open access group and only 2 patients in the laparoscopic plastic group. Postoperative complications were observed in 34 patients who underwent surgical treatment through open access, and in 15 patients – by laparoscopy. Conclusions. The laparoscopic approach of inguinal hernia surgery is superior to open access, as it reduces the length of hospital stay, postoperative recovery, improves the aesthetic effect of the operation, reduces the frequency of infection of incisions. According to the results of the study, this technique gives a better result in the early postoperative period, a lower percentage of chronic pain and a higher degree of patient satisfaction compared to open access with the same low recurrence rate. Therefore, in our opinion, laparoscopic access to hernioplasty is the optimal method of treatment and can be recommended as a method of choosing inguinal hernia surgery. Postoperative assessment of the quality of life of patients after treatment of inguinal hernia by laparoscopic and open methods. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: inguinal hernia, laparoscopy, open access surgery, analysis of methods, operation.

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PREVENTION OF POST SPINAL HYPOTENSION;

The Professional Medical Journal ◽

10.29309/tpmj/2012.19.03.2114 ◽

2012 ◽

Vol 19 (03) ◽

pp. 292-296

Author(s):

MUHAMMAD BOOTA ◽

BILAL Baig ◽

SALEEM IQBAL ◽

Sajid Munir ◽

Syed Tariq Mohsin

Keyword(s):

Heart Rate ◽

Inguinal Hernia ◽

Arterial Pressure ◽

Elderly Patients ◽

Systolic Arterial Pressure ◽

Hernia Surgery ◽

Inguinal Hernia Surgery ◽

Number Of Patients ◽

Paravertebral Muscles ◽

Spinal Hypotension

Objective: Objective of the study is to evaluate the efficacy of intramuscular ephedrine along with preloading in prevention ofpost spinal hypotension in elderly patients undergoing inguinal hernia surgery. Study design: This is a quasi experimental study. Place andduration of study: The study was conducted at the department of Anaesthesia and Intensive Care Combined Military Hospital, Peshawar overa period of one year. Patients and Methods: In a double-blind, randomized study, 80 elderly patients undergoing inguinal hernia surgery underspinal anaesthesia divided into two equal groups of A and B. Forty patients received i/m inj of ephedrine 45mg deep in the paravertebralmuscles immediately after injection of bupivacaine, and 40 received an equal volume of saline. Patients in both groups were given the samevolumes of fluid before anaesthesia. The incidence of hypotension (Systolic arterial pressure <90mmHg or <80 % of baseline) were recorded.and incidence of fall in the heart rate was recorded. Results: Systolic arterial pressure during the first 60 min after anaesthesia remainedsignificantly more stable in the ephedrine-treated group, and there was also a significantly smaller number of patients in this group who haddecreases in pressure of more than 30% of pre-block levels and fewer required rescue i.v. Ephedrine. An increase in heart rate or systolicpressure of > 20% from baseline was found in two patients in the ephedrine group and in one patient in the placebo group. Conclusions: Weconclude that ephedrine 45mg administered in the paravertebral muscles immediately after plain bupivacaine spinal anaesthesia is a simpleand effective means of reducing the incidence of hypotensive episodes in the elderly patient.

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A PROSPECTIVE STUDY OF N-BUTYL CYANO ACRYLATE GLUE FIXATION VERSUS SUTURE FIXATION OF MESH IN OPEN REPAIR OF INGUINAL HERNIA

10.36106/ijsr/0500889 ◽

2021 ◽

pp. 21-24

Author(s):

Shiv Kumar Bunkar ◽

Anushree Jhunjhunwala ◽

Kalpana Agrawal

Keyword(s):

Chronic Pain ◽

Inguinal Hernia ◽

Controlled Study ◽

Cyanoacrylate Glue ◽

Hernia Surgery ◽

Post Operative Period ◽

Inguinal Hernia Surgery ◽

Post Operative Pain ◽

Duration Of Surgery ◽

Suture Group

BACKGROUND: The face of inguinal hernia surgery has been under constant evolution with improvements in surgical technique; together with the development of new prosthetic materials and a better understanding of how to use them. Till date, prevention of recurrence was the primary goal of any hernia surgery. With the advent of newer techniques the current focus has shifted to minimizing post-operative pain while continuing to ensure that the primary goal is met. The objective of our study was to compare suture xation of the mesh with non-mechanical xation using nbutyl cyanoacrylate (NBCA) glue for open inguinal hernia repair. METHODS: A prospective randomized controlled study was carried out at the General surgery department of J.L.N. Hospital, Ajmer between January 2019 and January 2020 consisting of 120 patients with uncomplicated inguinal hernia undergoing standard Lichenstein's mesh hernioplasty. Endpoints studied were postoperative acute and chronic pain, analgesic requirement in the post-operative period, duration of surgery and complications in the post operative period. RESULTS: Operative time was signicantly lesser in glue group as compare to suture group. There was no signicant difference in the post-operative pain during the entire timeline except at 24 hrs post procedure. However, 2 patients in suture group had chronic pain and complained of mild pain at 6 months follow up and even beyond. Post-operative complications were comparable in both groups. CONCLUSION: Our study help us to conclude that mesh xation with N butyl 2 cyanoacrylate glue is superior to sutures in several aspects.

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A comparative study of negative suction drainage in inguinal hernia operations at Saraswathi Institute of Medical Sciences, Pilkhua, Hapur Uttar Pradesh

International Surgery Journal ◽

10.18203/2349-2902.isj20215151 ◽

2021 ◽

Vol 9 (1) ◽

pp. 169

Author(s):

Desh Pal Singh ◽

Saurabh Goel ◽

Surendra Kumar

Keyword(s):

Inguinal Hernia ◽

Abdominal Wall ◽

Suction Drainage ◽

Hernia Surgery ◽

Old Patients ◽

Suction Drain ◽

Inguinal Hernias ◽

Inguinal Hernia Surgery ◽

Negative Suction ◽

Lower Abdominal Wall

Background: The inguinal area is the weakest region of the abdominal wall. So, this is the most common site for the development of hernias. Inguinal hernias are the commonest amongst all the hernias and hernia repair is the most frequently done operation worldwide. There is no agreement among surgeons regarding the need for drains. Some use sparingly and some use it routinely. This study aims to evaluate the use of negative suction drain in inguinal hernia surgery.Methods: We studied sixty patients of inguinal hernias both direct and indirect for one year and followed up for next 1-2 years. This prospective study aimed to see the effect of negative suction drainage in hernia surgery.Results: Both the groups did well postoperatively. It was beneficial to put a negative suction drain in those patients who had a bigger hernia, fatty patients with the thick fatty lower abdominal wall and older patients.Conclusion: It is advisable to put a negative suction drain in inguinal hernia surgery and strongly advocated if the dissection had been difficult, old patients and fatty lower abdominal wall

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Comparison of the effect of ginger capsule and diclofenac tablet on the relief of pain following inguinal hernia surgery

Journal of Shahrekord University of Medical Sciences ◽

10.34172/jsums.2019.20 ◽

2019 ◽

Vol 21 (3) ◽

pp. 114-117

Author(s):

Gholamreza Shabanian ◽

Ali Satari

Keyword(s):

Inguinal Hernia ◽

Negative Effects ◽

Postoperative Pain Control ◽

Hernia Surgery ◽

Analgesic Effects ◽

Inguinal Hernia Surgery ◽

Number Of Patients ◽

Significant Difference ◽

Health Domains ◽

Duration Of Hospitalization

Background and aims: Postoperative pain control decreases negative effects on the health domains of the patients and their relatives in addition to reducing the costs and the duration of hospitalization. The aim of the present study was to comparatively investigate the analgesic effects of ginger and diclofenac tablets. Materials and Methods: In this clinical trial, 80 patients undergoing inguinal hernia surgery were randomly divided into two groups of 40. One group received 250 mg ginger capsule while the other one received 100 mg diclofenac tablet. Then, the patients were examined within 6 hours (every two hours) and their pain was assessed using the standard 10-point visual analogue scale. Finally, the data were analyzed using the SPSS, version 22. Results: Based on the results, there was no significant difference in pain severity between the two groups at 0, 2, 4, and 6 hours after recovery (P>0.05). In addition, no significant difference was observed in the duration of pain since the time of patient recovery between the two groups (P>0.05). Further, as regards the number of patients receiving pethidine, no difference was found between the two groups (P>0.05). Conclusion: In general, both ginger capsule and diclofenac tablet were similarly effective in relieving the pain after inguinal hernia surgery

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Amyand’s Hernia: A Rare Case Report

Berkala Kedokteran ◽

10.20527/jbk.v17i2.11677 ◽

2021 ◽

Vol 17 (2) ◽

pp. 159

Author(s):

Fadli Robby Amsriza ◽

Rizka Fakhriani

Keyword(s):

Inguinal Hernia ◽

Elective Surgery ◽

Correct Diagnosis ◽

Rare Condition ◽

Treatment Method ◽

Amyand’S Hernia ◽

Hernia Surgery ◽

Hernia Sac ◽

Inguinal Hernia Surgery ◽

The Right

Abstract: Amyand’s hernia is described in the inguinal hernia sac as being the presence of an appendix vermiformis. It is a rare condition the incidence is about 1 per cent of all inguinal hernias. It is often diagnosed incidentally during inguinal hernia surgery. The main treatment method of Amyand’s hernia is surgery. We report a case of 63 years old man who presented with right inguinal groin bulge for 1 month with the previous repaired right inguinal hernia 5 years ago. On clinical examination revealed a 6 cmx8 cm firm, nontender, irreponible mass in the right inguinal region. He was diagnosed as right sided irreponible inguinal hernia. He was undergoing the elective surgery. Intra-operative, the hernia sac was laterally found in the inferior epigastric vessels and separated from sperm cord to deep inguinal ring. The hernia sac was opened. A non-inflamed appendix was seen. Appendectomy was performed, and the hernia was repaired by Halsted’s repair. Amyand’s hernia is a rare condition. The correct diagnosis is usually made intraoperative. Keywords: Amyand’s hernia, appendectomy, hernia repair, inguinal hernia.

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Inguinal hernia repair: can one identify the three main nerves of the region?

Revista do Colégio Brasileiro de Cirurgiões ◽

10.1590/0100-69912015003004 ◽

2015 ◽

Vol 42 (3) ◽

pp. 149-153 ◽

Cited By ~ 4

Author(s):

João Vicente Machado Grossi ◽

Leandro Totti Cavazzola ◽

Ricardo Breigeiron

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Randomized Study ◽

Operating Time ◽

Hernia Surgery ◽

Nerve Branch ◽

Ilioinguinal Nerve ◽

Inguinal Hernia Surgery ◽

The Right

<sec><title>OBJECTIVE:</title> To identify the nerves in the groin during inguinal hernia repair by inguinotomy.</sec><sec><title>METHODS:</title> We conducted a prospective, sequenced, non-randomized study comprising 38 patients undergoing inguinal hernia repair with placement of polypropylene mesh.</sec><sec><title>RESULTS:</title> The male patients were 36 (94.7%), with a mean age and standard deviation of 43.1 ± 14.5, body mass index of 24.4 ± 2.8. Comorbidities were hypertension in two (5.2%), smoking in 12 (31.5%) and obesity in two (5.2%). The hernia was located only on the right in 21 (55.2%) patients, only on the left in 11 (28.9%), and was bilateral in six (15.7%) patients. Prior hernia repair was present in seven (18.4%) patients. The identification of the three nerves during operation was made in 20 (52.6%) patients, the ilioinguinal nerve and the iliohypogastric nerve were identified in 33 (86.8%), and the genital nerve branch of the genitofemoral nerve, in 20 (52.6%). Resection of at least one of the nerves was performed in seven (18.4%) cases, two iliohypogastric nerves and five ilioinguinal nerves. The average operating time was 70.8 ± 18.2 minutes. The hospital stay was 1.42 ± 1.18 days. Ten patients (26.3%) returned to physical activity around the first postoperative visit, and 37 (97.3%) in the last. The follow-up time was 95.6 ± 23.5 days. The inability to identify the ilioinguinal nerve was associated with previous repair (p = 0.035).</sec><sec><title>CONCLUSION:</title> The identification of the three nerves during inguinal hernia surgery has been described in more than half of the cases and prior repair interfered with the identification of ilioinguinal nerve.</sec>

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