PROFILE OF THE PATIENTS WHO UNDERWENT PROLENE HERNIA SYSTEM EXTENDED FOR INGUINAL HERNIA IN A TEACHING INSTITUTE IN SUBHIMALAYAN REGION

Introduction: Worldwide, inguinal hernia repair is probably the most commonly performed general surgical procedure. Hence, a slight refinement of surgical repair of inguinal hernia would mean a substantial benefit to the patient. Aim: The study aimed to study profile of the patients who underwent Prolene Hernia System Extended (PHSE) for Inguinal Hernia in a teaching institute in Sub-Himalayan region. Materials and Methods: This was a controlled study conducted over 30 adult patients of both genders admitted at Dr RPGMC Tanda at Kangra from September 2016 to September 2017. Patients clinically diagnosed with inguinal hernias both direct and indirect on examination were enrolled in the trial after their informed consent. Results: Mean age of the patients was 54.9±13.66 years (range 30 to 80 years). 33% of the patients were elderly. All the patients were males. 43% of the patients were smokers and 53% were consuming alcohol. 20% of the patients had associated co-morbidities. 7% patients had previous history of surgery. Fifty percent of the patients had direct hernia while 33% had indirect hernia. Among 10% patients, it was bubonocele type. Seven patients had complications. Scrotal swelling was the most common welling (n=3) followed by inguinodynia (n=2), and seroma formation and urinary retention in one patient each. Conclusion: PHSE for management of inguinal hernia is associated with better outcomes.

Prolene Hernia System Herniorraphy Versus Open Inguinal Hernia Repair by Lichtenstein Tension Free Mesh Hernioplasty -A Randomized Study

Prolene Hernia System is a tension free anterior inguinal hernia repair using a bilayered modification of inguinal hernia mesh. Inguinal hernia repair by Prolene is comparable with almost equal operating time, smaller incision and with a trend towards decreased complications rate and reduced rate of recurrences. This study was conducted to study and to compare the results of Prolene Hernia System and Lichtenstein Tension Free mesh hernioplasty with respect to its operative time, post-operative pain, intra/post-operative complications and total hospital stay. The effectiveness of PHS were compared to Lichtenstein tension free mesh hernias repair in patients presenting with uncomplicated Inguinal Hernia for elective surgery in the Surgery department of IGMC, Shimla. Duration of surgery was shorter in Prolene Hernia System group (p=0.04) than the Lichtenstein tension free mesh hernioplasty [32 vs 34 minutes], The mean pain intensity in present study was 2.9 in Lichtenstein tension free mesh hernioplasty group and 2.7 in Prolene Hernia System, No intra-operative complications were seen with either of the two groups. Post-operative complications in the form of Seroma formation were more in Lichtenstein tension free mesh hernioplasty group than Prolene Hernia System group (8 vs 0). There were two cases of recurrence in the Lichtenstein tension free mesh hernioplasty group, while no short-term recurrence was seen in Prolene Hernia System group over 12 weeks. Mean duration of post-operative hospital stay was 1.57 days for Lichtenstein tension free mesh hernioplasty group and 1.33 days for Prolene Hernia System group. This study concludes that even though the difference between the two methods in this randomized study were small, the Prolene Hernia System repair method for open inguinal hernia repair was associated with a shorter operative time, lower rate of recurrence, as well as fewer complications when compared with the Lichtenstein tension free mesh hernioplasty. Further prospective studies are needed to rigorously evaluate the comparative advantages of Prolene Hernia System repair in relation to other repair methods

A comparative study of Lichtenstein tension free hernioplasty with prolene hernia system hernioplasty for ingunial hernia

Background: Lichtenstein tension-free hernioplasty (LTH) has become the gold standard for hernia repair. It is easy to learn and perform with minimal complications and low recurrence rate. But it deals with only superior half of the myopectineal orifice. Prolene hernia system (PHS) hernioplasty is safe, causes minimal pain and has minimal recurrence rate but is still not popular due to high cost. The aim of the study is to compare the Lichtenstein tension-free hernioplasty with hernioplasty using prolene hernia system.Methods: A total of 60 patients with inguinal hernia were equally grouped into cases (PHS) and controls (LTH). Outcome measures were compared with regards to postoperative pain, hospital stay and complications.Results: There was no significant difference in mean days of post-operative hospital stay among cases and controls. On post-operative days 1 and 3, most of the patients experienced moderate pain and by 8th post-operative day most of the patients had no pain. The pain intensity decreased with increase in post-operative days. Seroma formation was seen among 2 (6.67%) cases (PHS) group in comparison to 3 (10.0%) controls (Lichtenstein) group. Post-operative wound infection was seen among 1 (3.33%) cases (PHS) group and controls (Lichtenstein) group each. Recurrence was seen neither among patients treated with either technique.Conclusions: Prolene Hernia System mesh repair could be a suitable alternative to time honored Lichtenstein hernia repair with added advantage of strengthening the whole of myopectineal orifice, and virtually eliminating any risk of recurrence.