A COMPARATIVE STUDY ON OUTCOMES OF OPEN & LAPAROSCOPIC REPAIR IN INGUINAL HERNIA IN A TERTIARY CARE CENTRE

Background: Over the last decade, the field of hernia surgery got a new transformation, with exponential growth in mesh technology. Laparoscopic hernia repair has remained a contentious issue since its inception. Though a variety of procedures performed; none can be termed as an ideal procedure as each one is accompanied by varied early and late complications. The most scientific way to conclude the superiority of one method over others is evidence-based medicine. Hence, we have conducted a study in our institute, to compare Lichtenstein tension-free open hernioplasty with Transabdominal pre-peritoneal repair (TAPP) comparing the intraoperative and early postoperative complications. Methods: Our study was a single-centre, prospective comparative study conducted on sixty-one patients, over a period of 2 years from August 2018 to August 2020. All the cases included in the study were uncomplicated inguinal hernias. A detailed history of the symptoms, thorough clinical examination and investigations were done, which were analysed. Results: Most of the patients presented in the 5th decade. Male to female ratio of incidence of inguinal hernia was 11.2:1. Majority of the patients presented with unilateral hernia with right inguinal hernia being the most frequent presentation. The mean duration of surgery for TAPP is more when compared to Lichtenstein operation. The mean duration of hospital stay for open hernioplasty is more when compared to the laparoscopic hernia repair. TAPP is associated with lesser complications when compared to Lichtenstein's hernioplasty. Seroma, hematoma, and wound infection were the common complications noted. Conclusion: TAPP repair is a better procedure when compared to Lichtenstein operation in terms of hospital stay, post- operative recovery, intra-operative and post-operative complications.

ANALYSIS OF SURGERY FOR INGUINAL HERNIA UNDER HERNIA CENTER

The purpose of research - to evaluate the spectrum of surgical procedures performed in patients with inguinal hernias, in clinical practice, surgical hospital in Moscow. Material and methods. Cross-sectional study carried out with sequential selection of all patients with inguinal hernias operated in a planned manner in the surgical clinic CCH № 1 named after N.I. Pirogov in Moscow in the period from September 1, 2017 on December 31, 2017 The study was observational in nature, exclusion criteria were not. The study included 175 patients with inguinal hernias. Found 201 inguinal hernia, made 201 hernioplasty. Results. 42 (20.9%) patients underwent “open” alloplastic - Liechtenstein operation (in all cases a one-sided). Videolaparoscopic intervention conducted 133 patients (26 in the hernia observations wore a bilateral nature, only 159 procedures (79.1%)). TAPP hernioplasty performed in 140 cases (69.6% of 118 patients) TER hernioplasty - in 19 (9.5%, 15 patients). Lichtenstein operation performed usually patients with large hernial ring (3 cm). Among patients who underwent intervention Endovideosurgery dominated patients with hernial ring to 1.5 cm. Also, among patients who underwent open surgery, patients are often met with oblique hernias. Furthermore, Liechtenstein operation was performed in patients with severe concomitant therapeutic pathology, inguinal-scrotal hernia, endotracheal failure of anesthesia. Complications in the immediate postoperative period, fixed in 1 (0.5%) patients - after TAPP formed preperitoneal hematoma. The mean hospital stay of 2.6 days. Signs of relapse of the disease, the formation of chronic pain, septic, and venous thromboembolic complications were recorded. Conclusion. The vast majority of operations for inguinal hernia in the CCH № 1 named after N.I. Pirogov during the reporting period 2017 Endovideosurgery satisfied (79.1%). The widespread introduction of minimally invasive technologies endovideosurgical work according to current clinical guidelines, training of employees, the formation of a significant flow profile allows patients to surgical hospital of the city hospital to assist patients with inguinal hernias at the level of the world standards.