A Prospective Study to Evaluate the Effectiveness of Prolene Mesh Repair in Incisional Hernia: A Hospital Based Study

Background: Inguinal hernia is the most common diversity accounting for roughly 75% of all hernia. The etiology of an inguinal hernia is clearly not understood. The technique of hernia repair is usually based on custom rather than evidence.4 According to data there is a good observation that open mesh repair is better than suture repair in terms of recurrences. The aim of this study to evaluated the effectiveness of prolene mesh rapair in incisional hernia.Subjects and Methods:A prospective hospital based study done on 30 cases in department of general surgery at RVRS medical college & associated group of hospitals, Bhilwara, Rajasthan. We randomly assigned 30 patients to suture repair or mesh repair of an incisional hernia. The patients were followed up by local physical examination at 1 month & 3 months were done as per standard protocol. Factors related to the operation including the surgical technique, presence or absence of seroma, hematoma, infection, dehiscence were recorded. Follow-up of cases was done at 1 month & 3 months after surgery on an outpatient basis for recurrence of hernia.Results:Our study showed that the majority of cases (43.33%) were seen in 40-49 years of age group. Small (0-5cm) gap size 90% cases and 10% cases have medium gap size in our study. Pain present in 26.66% patients in group A and 20% in group B at 1 month. The recurrence of hernia was present in 28% cases in group A and 4% in group B. It was statistically significant (P=0.0488*) at 3 months and the mostly were well built and have 27.27% wound infection present in these type of patients. Mostly infection occurred in obese patients (40%).Conclusion: We concluded that restoration with polypropylene mesh is superior to suture repair group with concern to the recurrence of hernia.

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Assessment and comparison of laparoscopic hernia repair versus open hernia: a non-randomized study

International Surgery Journal ◽

10.18203/2349-2902.isj20180823 ◽

2018 ◽

Vol 5 (3) ◽

pp. 1021

Author(s):

P. Krishna Murthy ◽

Dilip Ravalia

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Mesh Repair ◽

Laparoscopic Hernia Repair ◽

Randomized Study ◽

Operating Time ◽

Fatty Tissue ◽

Open Mesh Repair ◽

Group A ◽

Group B

Background: Hernia is the abnormal exit of an organ or fatty tissue, such as the bowel, through the wall of the cavity in which it normally resides. Repair of inguinal hernia is one of the common surgical procedures done worldwide. Present study was performed with an aim to compare the effectiveness of laparoscopic hernia repair and Lichtenstein’s hernioplasty and to know for any special pre-operative/ intra operative requirements for surgery.Methods: Present study is a non-randomized comparative study. The study consisted 50 patients treated with Hernioplasty (20 cases of laparoscopic hernioplasty and 30 cases of open hernioplasty in the Department of General Surgery, during the study period of one year. Data were collected using a questionnaire.Results: Mean operating time in group A was 92.25 minutes while in group B was 43.5 minutes, which is significantly supplementary. Pain score was significantly less in group A with 75% patients giving score 1-2 (mild pain) and 3 patients with discomforting pain with p<0.05.Conclusions: laparoscopic pre-peritoneal mesh repair of inguinal hernia is safe and efficacious and offers definitive advantages over open mesh repair and should be an available option for all patients requiring elective Hernioplasty.

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Outcome of tension free open mesh repair of inguinal hernia

Journal of Surgical Sciences ◽

10.3329/jss.v22i1.44010 ◽

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

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The Outcome Comparison of two Groups of total Extraperitoneal and Mesh Repair of Inguinal Hernia

10.53350/pjmhs2115102712 ◽

2021 ◽

Vol 15 (10) ◽

pp. 2712-2714

Author(s):

Muhammad Aamir Jamil ◽

Muhammad Asif ◽

Imran Yousaf ◽

Muhammad Faheem Anwer ◽

Muhammad Waseem Anwar

Keyword(s):

Inguinal Hernia ◽

Hospital Stay ◽

Recovery Time ◽

Mesh Repair ◽

Operative Procedure ◽

Total Extraperitoneal ◽

Outcome Comparison ◽

Group A ◽

The Mean ◽

Group B

Aim: The outcome comparison of total extraperitoneal versus mesh repair for inguinal hernia. Study design: Quasi experimental study. Place and duration of study: Department of Surgery, M. Islam Teaching Hospital, Gujranwala from March 2018 to March 2019. Methodology: After the approval of hospital ethical committee, a total of 50 patients were included and randomly divided into two groups equally. Group A (Total extraperitoneal), Group B (Mesh repair). An informed consent was taken from every patient about operative procedure and the outcome. A detailed history of the patient i.e. clinical examination, routine investigations (CBC, Urine R/E, urea, creatinine) and some specific investigations (chest X-ray, ECG and ultrasound abdomen and prostate) was done for surgery. All data of patients was collected on proforma and was analyzed with the help of a computer SPSS programme 20. Results: The mean age of patients was 34.22±11.54 years in group A and 35.63±11.25 years in group B. All male and female patients included in this study in both groups. Twelve (48%) of patients were direct inguinal hernia in group A 13(22%) were in group B and 14(56%) patients were in group A and 11(44%) patients were in group B. The mean±SD postoperative hospital stay was 24.48±4.62 in group A and 34.65±12.26 hours in group B (p 0.001). The mean±SD postoperative recovery time in weeks was 2.18±0.43 in group A and 2.90±0.46 weeks in group B (p 0.001). Only 2 (4%) patient had postoperative infection on first week and 4 (8%) patients had infection respectively. No recurrence was seen in group A and only 3% recurrence was in group B. Conclusion: It is concluded that group A had shorter hospital stay, recovery time, postoperative time and less infection rate as compared to group B. In group A 13% patients had severe pain and in group B 25% patients. Keywords: Inguinal Hernia, Total extraperitoneal, Mesh repair.

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A prospective study on incisional hernia, its incidence, etiology and management in a tertiary care hospital of Odisha

International Surgery Journal ◽

10.18203/2349-2902.isj20191263 ◽

2019 ◽

Vol 6 (4) ◽

pp. 1280

Author(s):

S. K. Pattanaik ◽

Afroza Firodous ◽

Ajax John ◽

Harsha Pattnaik ◽

Biplab Mishra ◽

...

Keyword(s):

Incisional Hernia ◽

Mesh Repair ◽

Tertiary Care ◽

Operating Time ◽

Surgical Techniques ◽

Wound Management ◽

Anatomical Reconstruction ◽

Suture Repair ◽

Care Hospital ◽

Open Mesh Repair

Background: Incisional hernia (IH) is defined as the hernia protruding through incompletely healed abdominal surgical wound. Management of IH can be preventive (avoidance of infection and suture line tension, proper abdominal wound closure) or operative (anatomical reconstruction or repair with synthetic non-absorbable mesh either by open or laparoscopy method).Methods: A descriptive prospective observational study on 51 patients with age >15 yrs was conducted in the Department of General Surgery, SCB Medical College and Hospital, Cuttack from August 2015 to August 2017. Diagnosis was made with clinical history, physical examination, X-ray abdomen and USG abdomen. The patients underwent different surgical procedures depending on size of defect, patient’s consent and expertise available. Post-operative complications were noted and patients were followed up to 1 year for any recurrence.Results: 28 males and 23 females were included. The mean age was 42.3 years. Most common cause of IH was post-operative wound infection (47.1%). Maximum cases were following emergency surgery (88.2%). Midline incision contributes maximum number (52.9%) followed by Pfannenstiel incision (25.4%). Open hernioplasty was the most common procedure (58.8%) followed by anatomical repair (19.6%) and laparoscopic hernioplasty (15.6%). Recurrence with suture repair was 10%, open mesh repair 3.3% and no recurrence was observed following laparoscopic repair.Conclusions: Prevention of IH is to be taken care of, by avoiding infection during index operation with thorough peritoneal toileting, proper surgical techniques and appropriate antibiotics. Although laparoscopic mesh repair needs more operating time and skill, it has lesser blood loss, hospital stay and recurrence rate when compared to other procedures.

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Comparison of post-operative pain after laparoscopic total extraperitoneal mesh repair of indirect inguinal hernia with tacker

10.53350/pjmhs2115102733 ◽

2021 ◽

Vol 15 (10) ◽

pp. 2733-2735

Author(s):

Shahid Hussain ◽

Asiya Shabbir ◽

Muhammad Asif

Keyword(s):

Inguinal Hernia ◽

Mesh Repair ◽

Indirect Inguinal Hernia ◽

Satisfactory Outcome ◽

Post Operative Pain ◽

Total Extraperitoneal ◽

Significant Difference ◽

Group A ◽

Group B ◽

Laparoscopic Tep

Objectives: To compare the post-operative pain after laparoscopic total extraperitoneal mesh repair of indirect inguinal hernia with tacker and without tacker fixation. Materials & Methods: This comparative study was done at Surgical Department of Bahawal Victoria Hospital, Bahawalpur from May 2020 to November 2020 over the period of 6 months. Total 182 patients with indirect inguinal hernia, having age range from 20 to 60 either male or female were selected. In group A patients, laparoscopic TEP mesh repair of inguinal hernia without tacker fixation was done while in group B patients, laparoscopic TEP mesh repair of inguinal hernia with tacker fixation was done. Patients were assessed for post-operative pain and outcome (satisfactory/unsatisfactory) at 1 month follow up. Results: Average of patients was 41.33 ± 12.37 years and 40.83 ± 12.04 years in group A and group B. Out of 182 patients, 170 (93.41%) were males and 12 (6.59%) were females. Mean post-operative pain in Group A was 1.46 ± 1.50 while in Group B was 1.77 ± 2.08 (p-value=0.2505). Satisfactory outcome was noted in 84 (92.31%) patients and 67 (73.63%) patients of group A and B and the difference was significant (P = 0.001). Conclusion: Results of this study showed that there is a significant difference of satisfactory outcome (less post-operative pain) between the non-fixation and fixation group. Difference of satisfactory outcome was also significant between male patients, diabetics and obese patients of both groups. Keywords: Inguinal hernia, laparoscopic, mesh, tacker fixation

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Long-term results of incisional hernia treatment

Medicina ◽

10.3390/medicina43110110 ◽

2007 ◽

Vol 43 (11) ◽

pp. 855 ◽

Cited By ~ 10

Author(s):

Linas Venclauskas ◽

Jolita Šilanskaitė ◽

Jurga Kanišauskaitė ◽

Mindaugas Kiudelis

Keyword(s):

Physical Activity ◽

Incisional Hernia ◽

Mesh Repair ◽

Study Groups ◽

Hernia Recurrence ◽

Suture Repair ◽

Open Mesh Repair ◽

Onlay Technique ◽

Open Mesh

Ventral hernia is a common problem in general surgery practice. Incisional hernia can develop in 15–25% of patients after abdominal surgery. The aim of this study was to compare two different methods of incisional hernia surgery. Materials and methods. A retrospective analysis of database of surgery department from 1997 to 2000 was performed. All patients were divided into two groups. The first group patients were operated using open suture repair (keel technique); the second group patients – using open mesh repair (onlay technique). Long-term follow-up was done by a mail questionnaire. A special questionnaire was sent to all patients. Postoperative evaluation included pain and discomfort in the abdomen, physical activity, and recurrence rate after operation. Statistical evaluation was conduced using descriptive analysis: the unpaired Student t test to compare parametric criterions between two study groups, Mann-Whitney U test to compare the unpaired nonparametric criterions between two study groups, and X2 test to investigate nonparametric criterions between these groups. Results. A total of 202 patients (51 males, 151 females) with incisional hernia were operated during 1997–2000. One hundred seventy-one patients were in the keel technique group, and 31 patients in the onlay technique group. There were no significantly differences in age and sex between these groups. The hospitalization time was significantly longer in the open mesh repair group. The postoperative complication (wound seroma and suppuration) rate was significantly higher in the onlay technique group. One hundred sixty-one patients (79.7%) answered the questionnaire (133 in the keel technique group, 28 the in onlay technique group). The patients’ return to physical activity after surgery was significantly longer in the keel technique group. Forty-one patients (31%) had hernia recurrence in the keel technique group and 3 patients (11%) in the onlay technique group (P<0.05). There were no postoperative deaths in both groups. Conclusions. The rates of postoperative therapeutic complications and hernia recurrence are significantly lower after open mesh repair surgery. Return to normal physical activity after surgery is significantly longer after open suture repair surgery.

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Comparison of local versus spinal anesthesia in long standing open inguinal hernia repair

International Surgery Journal ◽

10.18203/2349-2902.isj20174889 ◽

2017 ◽

Vol 4 (11) ◽

pp. 3701 ◽

Cited By ~ 2

Author(s):

Anubhav Goel ◽

Ankur Bansal ◽

Akash Singh

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Spinal Anesthesia ◽

Inguinal Hernia Repair ◽

Local Anesthesia ◽

Mesh Repair ◽

Hernia Mesh ◽

Group A ◽

Group B ◽

Hernia Mesh Repair

Background: Hernias are among the oldest known afflictions of human kind and elective inguinal hernia repair is commonly performed operation in general surgery. General or spinal anesthesia are still the most common types of anesthesia being used in India. Studies comparing the recovery profiles of local, general and regional anesthesia show that local anesthesia is ideal for day care surgery.Methods: This study had included 60 cases of male single sided reducible indirect long standing (more than 5 years) inguinal hernia. Patients were divided randomly into two groups of 30 each named Group A and Group B. Patients in group A were subjected to inguinal hernia mesh repair under local anesthesia and patients in group B were subjected to inguinal hernia mesh repair under spinal anesthesia. Tension free Lichtenstein hernioplasty was done in both groups.Results: Time taken in local anesthesia is higher than spinal anesthesia. Intraoperative pain is higher in local anesthesia than spinal anesthesia. There is no difference on post-operative pain. Post-operative complications are more in spinal anesthesia group.Conclusions: Patient selection is very important and patient with long history should be avoided under local anesthesia.

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Comparison of Post-Operative Complications Between Sublay and Onlay Mesh Repair in Incisional Hernia

10.53350/pjmhs2115123384 ◽

2021 ◽

Vol 15 (12) ◽

pp. 3384-3386

Author(s):

Azizullah Khan Sherani ◽

Saleem Javed ◽

Muhammad Idrees Achackzai

Keyword(s):

Incisional Hernia ◽

Wound Infection ◽

Mesh Repair ◽

Seroma Formation ◽

Onlay Technique ◽

Sublay Technique ◽

Operative Complications ◽

Group A ◽

Group B ◽

Post Operative Complications

Objective: To compare the post-operative complications between sublay and onlay mesh repair in incisional hernia. Materials & Methods: This randomized controlled trial was conducted at Department of Surgery, Sandeman Provincial Hospital Quetta from May 2019 to November 2019. Total 250 patients with incisional hernias for more than 3 months, having age 20-40 years either male or female were selected. Then selected patients were placed randomly into two groups i.e. Group A (Sublay group) & Group B (Onlay group), by using lottery method. Patients were called for follow up 15th day for post-operative complications in term of wound infection and seroma formation. Results: The mean age of patients in group A was 34.73 ± 4.32 years and in group B was 34.51 ± 4.67 years. Out of these 250 patients, 161 (64.40%) were female and 89 (35.60%) were males with female to male ratio of 1.8:1. Wound infection was seen in 07 (5.60%) patients in group A (Sublay technique) and 17 (13.60%) patients in group B (Onlay technique) with p-value of 0.033. Seroma formation was seen in 09 (7.20%) patients in group A (Sublay technique) and 26 (20.80%) patients in group B (Onlay technique) with p-value of 0.002. Conclusion: This study concluded that rate of wound infection and seroma formation is less after sublay mesh repair for incisional hernia as compared to onlay repair. Keywords: Hernia, incisional, onlay, sublay, seroma.

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Tension-Free Mesh Repair for Incarcerated Groin Hernia: A Comparative Study

Surgical Innovation ◽

10.1177/1553350620901392 ◽

2020 ◽

pp. 155335062090139

Author(s):

Fuqiang Chen ◽

Min Liu ◽

Cuihong Jin ◽

Fan Wang ◽

Yingmo Shen ◽

...

Keyword(s):

Mesh Repair ◽

Groin Hernia ◽

Biological Mesh ◽

Suture Repair ◽

Lichtenstein Repair ◽

Tension Free ◽

Group A ◽

Group B ◽

Incarcerated Groin Hernia

Background. Management of emergent groin hernias remains challenging, due to limited consensus in surgical approach and repair options (eg, mesh vs nonmesh, biological mesh, and polypropylene [PP] mesh). Methods. A 5-year retrospective study was conducted on 118 patients who received emergency incarcerated groin hernia repair in Beijing Chaoyang Hospital. The incidence of surgical site infection (SSI), preoperative mortality, sepsis, and ileus was noted. In the follow-up, postoperative foreign body sensation, chronic pain, seroma/hematoma, and recurrence were recorded. The outcomes of different surgical procedures (with mesh/without mesh, biological mesh/PP mesh, transabdominal preperitoneal (TAPP)/Lichtenstein repair) were compared and analyzed. Results. Out of the 118 patients, 14 cases received suture repair (as group A); 104 cases had TAPP repair (n = 44) or Lichtenstein repair (n = 60) with meshes, including 23 cases of biological mesh (as group B); and 81 cases had repair with PP mesh (group C). There were no significant differences between the 3 groups regarding SSI, mortality, sepsis, and ileus. After 20.5 months of follow-up (range from 6 to 65 months), 21.4% of group A developed recurrence, a rate significantly higher than that of group B (4.3%) and group C (0). The incidence of seroma/hematoma in group B was higher than that in group A (7.1%) and group C (7.4%). The results between TAPP group and Lichtenstein group were comparable. Conclusion. Tension-free mesh repair in the treatment of emergency incarcerated groin hernia is safe and effective, which can reduce hernia recurrence without increasing infection risk. The results of biological mesh and PP mesh were comparable.

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VENTRAL INCISIONAL HERNIAS

The Professional Medical Journal ◽

10.29309/tpmj/2011.18.02.2057 ◽

2011 ◽

Vol 18 (02) ◽

pp. 228-232

Author(s):

HAROON JAVAID MAJID ◽

HARUN MAJID DAR ◽

MUHAMMAD SHAFI ◽

Muhammad Arif Javed

Keyword(s):

Incisional Hernia ◽

Mesh Repair ◽

Randomized Clinical Trials ◽

Incisional Hernia Repair ◽

Suture Repair ◽

Recurrence Rates ◽

Incisional Hernias ◽

Number Of Patients ◽

Open Mesh Repair ◽

Ventral Incisional Hernia

Ventral Incisional Hernias are a well known complication after abdominal surgery with a reported incidence of 10% - 20% and a recurrence rate of 30% - 50% after open suture repair and less than 10% after open mesh repair. Objectives: To compare the outcome of two different methods of open repair of VIH (i.e. Mesh versus Non-mesh or Suture Repair in terms of morbidity, complications and recurrence. Period: 11 years period (January 2000 – December 2010). Setting: Shaikh Zayed Hospital, Lahore. Patients & Methods: The total number of patients who underwent surgery for repair of VIH during the study period was 321.There were only 33 patients in Group A (simple suture/Keel repair) while Group B had 288 patients. The most common early postoperative complications seen in both the groups were wound seroma and infection. Post-operative respiratory insufficiency was more common in the obese. Chronic pain and feeling of foreign body was more frequently seen in the mesh group. On the other hand, recurrence rates were far greater in the suture repair group. The overall mortality in the whole series was 3 patients (0.93%). Conclusions: The rates of ventral incisional hernia recurrence and complications are significantly lower after open onlay mesh repair as compared to the open suture repair. However, these results require confirmation by prospective randomized clinical trials which should also include the results of laparoscopic ventral incisional hernia repair which is a new and emerging technique in Pakistan.

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