A PROSPECTIVE STUDY OF RESULTS OF MESH HERNIOPLASTY AND MODIFIED DARNING IN PRIMARY INGUINAL HERNIA

INTRODUCTION: Hernia may be generally dened as a protrusion of abdominal viscera or a part of viscera outside the abdominal cavity through a natural or acquired defect. This denition, however, does not includeinternal hernias in which abdominal viscera, usually the small bowel, enter preformed intraperitoneal sacs commonly found around the duodenum, cecum, and sigmoid colon. AIMS AND OBJECTIVES: Inguinal hernia is one of the commonest surgical operations performed. There are many ways of repairing an inguinal hernia. Various techniques claim superiority over one another. The preferred method of inguinal hernia repair at all centres, particularly training institutes, utilize mesh because recurrence rates are low. However, it is shown that the less costly technique of “Darning” has the same incidence of complications and recurrence. This emphasizes the importance of training and supervision no matter which technique is employed. MATERIALS AND METHODS: Synthetic Non absorbable monolament material like polypropylene mesh andProlinne 2-0 Suture inGroin hernia repair. Patients with Groin hernia attending at OPD of SSKM Hospital and. CNMC&H, Kolkata, West Bengal. In SSKM Hospital-MARCH 2017 – SEPTEMBER 2018 and CNMC&H OCTOBER 2018- MARCH 2021, N=200 (n=100 in each group.) Randomized prospective parallel group study. RESULTS AND ANALYSIS: In proline darning, 8 patients had neuralgia Complications after hernia repair-( late>7 days) and 4 patients had scar tenderness Complications after hernia repair- (late >7 days) . In our study,72(72%) patients had Proline darning RIH Diagnosis, 4(4%) patients had Proline darning BLIH Diagnosis and 24(24%) patients had Proline darning LIH Diagnosis. SUMMARY: Thus the above study shows that there is no signicant difference between mesh/darn method of repair of primary inguinal hernia in terms of postoperative complications, duration of hospital stay, time of surgery, day off work provided necessary surgical skill, patient compliance, facilities are available. Though darning requires expertise in maintaining no tension during surgery, with little experience one can perform it with case and results similar to mesh repair. It is the cheaper and effective alternative to mesh repair in remote areas where availability of mesh and other facilities are difcult. CONCLUSION: So endogenous tissue is always superior to any foreign material once the mesh becomes infected it becomes resistant to healing and present with persistent sinus or stula or abscess. Source control is the applied histology of any inammatory process. Its foundation lies in the optimal harnessing off the process of inammation and tissue repair to expedite the resolution of infection. Endomesh created by using the endogenous tissue, internal oblique and transversusabdominis muscle and the use of redundanthernial sac is the future of herniorrhaphy operation.

COMPARATIVE CLINICAL STUDY OF NON-MESH VERSUS MESH REPAIR IN PRIMARY INGUINAL HERNIA

Background: The inguinal regions are one of the natural weak areas in the abdominal wall and are the most common site of herniation. Inguinal hernia repair is one of the most frequently performed operations. Amis: The aim of this study is to compare open mesh and non-mesh suture repair of primary inguinal hernias with respect to clinical outcome which include postoperative pain, complications, time of return to work and recurrence. Matierial and methods: This prospective study of 102 cases of primary inguinal hernia repair was carried out at M.G.M. Medical College & L.S.K. Hospital, Kishanganj with the aim of comparing open mesh and non-mesh suture repair with respect to clinical outcome which included postoperative pain, complications time of return to work and recurrence. Result: In our study there were no specific criteria for allocation of the method of repair and of 102 patients 52 patients randomly underwent non-mesh repair and 50 patients underwent mesh repair. Conclusion: The use of prosthetic mesh allows tension-free repair of inguinal hernia and in theory better results. Our study proves the superiority of this method over non-mesh repair in the long term with regard to hernia recurrence; in addition, there were less complications and postoperative pain.

Desarda versus Lichenstein technique for primary inguinal hernia treatment: one year results of a randomised clinical trial

Background: The ideal operation to treat inguinal hernia is still far to define. The Shouldice method and other tissue-based techniques are still acknowledged to be acceptable for primary inguinal hernia repair according to European Hernia Society guidelines. Desarda’s technique, presented in 2001, is an original hernia repair method using an undetached strip of external oblique aponeurosis. This randomized trial compared outcomes after hernia repair with Desarda and mesh-based Lichtenstein techniques.Methods: A total of 42 participants (40 males and 2 females) were randomly assigned to the Desarda (group 1) and Lichtenstein (group 2), 19 vs 23 respectively. The primary outcomes measured were recurrence (for maximum follow up of 1 year and minimum of 5 months) and chronic pain. Additionally, operative time, early and late complications, foreign body sensation, and return to everyday activity were examined in hospital and at 7, 30 days, and 6, 12 months after surgery.Results: During the follow-up, one recurrence was observed in Desarda group after 10 months of surgery. Chronic pain was experienced by 10.5% and 8.7% of patients from groups Desarda and Lichtenstein respectively. Foreign body sensation and return to activity were comparable between the two groups. Operative time was less in Desarda group. There was significantly less seroma production in the Desarda group.Conclusions: The results of primary inguinal hernia repair with the Desarda and Lichtenstein techniques are comparable at the 1 year follow up. The technique may potentially increase the number of tissue-based methods available for treating groin hernias.