What has changed in 20 years in Abdominal Wall Hernia Repairments Performed in Two Hospitals in Adana?

INTRODUCTION: The aim of this study was to evaluate the developments in the last 20 years regarding abdominal wall hernia repairments by examining the surgery records performed in the General Surgery Clinics of two large hospitals in Adana. METHODS: This cross-sectional and descriptive study was conducted in two stages. In the first stage, abdominal wall hernia repairments performed in Adana Numune Training and Research Hospital between 01.01.1999-31.12.1999 were analyzed. In the second stage, operations performed in Adana Seyhan State Hospital between 01.01.2019-31.12.2019 were analyzed by using medical records. The following parameters were compared for 1999 and 2019: age, gender, type of hernia, being unilateral or bilateral, emergency or elective operation, recurrence constellation, operation technique and type of mesh. RESULTS: In the first stage of the study, 391 operations were performed with bilateral repairs on 379 cases. The mean age of the patients was 49.0(±3.7) and median was 43 years, 62.2%(n = 263) were male, 41.4% (n = 157) were between 45-64 years of age. The most common type of hernia was inguinal hernia with 72.0%(n = 273) and the rate was 7.8 times higher in male than in female. The most common surgical technique was Bassini repair(42.4%, n = 166). In the second stage of the study, 1719 operations were performed with bilateral repairs on 1680 cases. The mean age of the patients was 49.4(±3.3) and median was 51 years, 65.9%(n = 1107) of them were male, 48.6%(n = 816) were between 45-64 years of age. The most common type of hernia was inguinal hernia with 50.4%(n = 848) and the rate was 16.6 times higher in male than in female. The most common surgical technique was Prolene Mesh Hernioraphy(73.1%, n = 1257). DISCUSSION AND CONCLUSION: In the last 20 years, it was determined that surgical repair techniques in abdominal wall hernias have changed a lot, and techniques such as Bassini, Shouldice, Halsted, McVay have been replaced by prosthetic mesh and laparoscopic repairs that provide less recurrence, less chronic pain and faster recovery time.

Inguinal Hernia

Approximately 700,000 inguinal hernia repairs are performed in the United States annually, making it one of the most commonly performed operations in surgical practice. The anatomy of the inguinal region is quite complex, and a thorough understanding of this region is required to successfully and safely repair these defects. The science of inguinal hernia repair continues to evolve and over the past several years has expanded to include laparoscopic and robotic approaches, as well as time-honored open repairs that still play an essential role in treating this disease process. The following review describes the relevant anatomy, types of groin hernias, the role of different hernia prostheses and meshes, common and evolving repair techniques, and the common complications encountered in hernia surgery, including chronic groin pain after inguinal hernia repair. The review contains 19 figures, 15 tables, and 50 references. Keywords: Inguinal hernia, femoral hernia, transabdominal preperitoneal repair, total extraperitoneal repair, laparoscopy, Bassini repair, Lichtenstein repair

Comparison of outcome of Desarda versus Bassini repair in management of complicated inguinal hernia

Background: Complicated inguinal hernia is a common problem faced by surgeons across the world. Various methods of surgical repair have been described. It is important to identify the best repair technique of inguinal hernia to have better post-operative outcome.Methods: This randomised controlled study consisted of 84 cases of complicated inguinal hernias presenting to surgical emergency department of Maulana Azad Medical College. Patients were randomly allocated to two repair groups- Desarda and Bassini and various intra/post-operative parameters were compared.Results: Duration of surgery and postoperative pain scores were less in Desarda group. Time to return to strenuous daily activities was also less with Desarda repair. Desarda repair was associated with less incidence of chronic inguinodynia and post-operative complications.Conclusions: Desarda repair was found to be superior to Bassini group due to shorter duration of surgery. Patients required less analgesics following Desarda repair as compared to Bassini group. There was no recurrence in any group at four months follow up.

Comparison of outcome of inguinal hernia repair by combined method of repair (Lichtenstein and Bassini repair) and its comparison with older techniques

Background: The aim of this study is to compare outcome of inguinal hernia repair by combined method of repair (Lichtenstein and Bassini repair) and its comparison with older techniques.Methods: A prospective study conducted on 158 patients reported in surgery OPD Patna Medical College and Hospital, Patna from July 2017 to June 2018 with inguinal hernia. All these patients were included in the study, operated by combined method of repair (Lichtenstein and Bassini repair) and followed up for 12 months. Data were entered and analyzed by SPSS version 10.0.Results: Study involved 158 patients who were operated by combined repair. Pain on 1st post-operative day was similar with previous study. Complication was erythema, scrotal swelling, neuralgia, superficial wound infection and seroma formation in the order of frequency. The average hospital stay was 5 days for combined approach. Recurrence rate was 0% in combined approach following 1 year of follow-up.Conclusions: As compared with previous studies of hernia repair by Modified Bassini’s and Lichenstein mesh hernioplasty, combined approach have comparatively better outcome.

Elective repair of uncomplicated inguinal hernia in south eastern nigerian

Aims and Objectives: Inguinal hernia repair is the most common operation in general surgery worldwide. Elective repair to safeguard complications is recommended because outcomes of early repair are uniformly superior to results of emergency operations. This study aimed to document our own experiences with regards to elective repair of uncomplicated inguinal hernia and compare our findings with previous data.Materials and Methods: This is a descriptive prospective study of 261 consecutive patients with uncomplicated inguinal hernias repaired electively at Federal Teaching Hospital, Abakaliki, southeastern Nigeria between January 2010 to December 2012. Relevant data extracted and analyzed with SPSS version 22.0 included patients’ demographics, clinical details, surgical repairs and outcome measures.Result: A total of two hundred and sixty one patients with 306 uncomplicated inguinal hernias repaired electively were enrolled. The age range of the patients was 2 months – 88 years with a mean age of 35.7 ± SD 16.6. Majority (46.4%) of the patients presented with hernias on the right side, the rest either had hernias on the left(36.4%) or both sides (17.2%). At operation, 203 (66.3%) hernias were indirect, 96 (31.4%) direct and 7 (2.3%) pantaloon hernias. Modified Bassini repair was used in the majority (66.7%) of patients. Complications occurred in only 9.7% of repairs. At a median follow up of 8 months, 1 (0.3%) hernia recurrence was seen. No mortality was recorded.Conclusion: Inguinal hernias in our environment are very common, but often neglected. Our results show that elective repair is critical for preventing devastating complications and ensuring successful surgical outcomes.Asian Journal of Medical Sciences Vol.7(2) 2015 90-95

DARNING VS BASSINI REPAIR FOR INGUINAL HERNIA

Introduction: Inguinal hernia repair is the most common surgical procedure performed after appendicectomy. There are many methods of repair practiced through out the world amongst which are the open hernia repairs and laparoscopic repair, two main types. Aims and Objectives: To find out the early recurrence within one year of the two open conventional methods, darn repair verses Bassini repair for the inguinal hernia. Patients and Methods: This study was carried out in the Surgical Unit 1 Allied hospital Faisalabad. One hundred adult male patients admitted in surgical unit I with clinical diagnosis of incomplete indirect inguinal hernia, were randomized to Bassini or Darning repair. Patients with contraindications for general anaesthesia, coagulation problems and those presenting with strangulated and obstructed hernia were excluded form the study. Results: Out of 100 patients, Fifty underwent Bassini repair with prolene and the other 50 had Moloney's Darn repair with prolene.65% of patients were in 20-24 yrs age group. Sixty four percent patients had right sided inguinal hernia.88 % had reducible inguinal hernia. In post operative complications, six patients with darn and 10 patients with Bassini had pain requiring strong analgesics. Haematoma was formed in 1 patient with darn and 2 patients with Bassini. Wound infection occurred in one patient with darn and three patients with Bassini. Only one patient with Bassini repair came back with recurrence after six months of operation. Conclusion: Bassini repair and Moloney's darn repair are comparable for young patients having primary hernia. However, Moloney's darn repair is superior in terms of post operative pain, need for analgesia and early ambulation.