Nigam’s inverted curtain hernioplasty: a modified lichtenstein tension free hernioplasty for inguinal hernia (original) (raw)
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International Journal of Medical Science And Diagnosis Research, 2022
It is a procedure where NICH is modified with basic repair, 2 stitches approximating inguinal ligament with conjoint tendon. Hundred patients were operated between April 2012 to April 2022 by modified NICH technique. All were primary uncomplicated cases of inguinal hernia. Modified NICH procedure for inguinal hernia takes care of recurrence better than any other procedure for inguinal hernia. Though NICH is a good modification of tension-free Lichtenstein procedure for inguinal hernia but modified NICH further improves the results specialty the recurrence. Modified NICH hernioplasty gives added advantages of repairing posterior inguinal wall which directly influences the recurrence rate. In our series of 100 cases no post-operative recurrence was noted. Though the series described here is small so more cases and more time is required to further confirm the results.
Inguinal Hernia Repair by Lichtenstein Tension-Free Hernioplasty Technique: Two Years Experiences
2021
Introduction; Inguinal hernia repair is one of the most commonly performed surgical procedures in the world. Most surgeons now prefer to perform a tension-free mesh repair. The Lichtenstein tension-free hernioplasty is currently one of the most popular techniques for the repair of inguinal hernias. The aim of this retrospective study was to evaluate the results of inguinal hernia repair using Lichtenstein the technique or free mesh tension over a period of two years. Materials and Methods: Four hundred and twenty-nine patients were administered at the University Hospital of Trauma, Tirana, Albania, who underwent inguinal hernia repair with the Lichtenstein-free-tension surgery technique from April 2016 - March 2018, were evaluated retrospectively in relation to demographics, recurrence, and postoperative complications. Follow-up data were taken from hospital schedules, recurrence and late complications were assessed in the telephone interview. Results: In our study, the total number...
Using mesh hernioplasty to patient with inguinal Hernia
AL-QADISIYAH MEDICAL JOURNAL, 2017
To clinically evaluate the outcome of Inguinal Hernioplasty in terms of haematoma, wound infection and recurrence, with special reference to surgery done by trainee surgeons. A total of 50 patients with inguinal hernia were operated during the study period. The result of the present study concluded that using mesh for surgical operation of hernia is much better than the ordinal operation of hernia because this technique reduces the recurrence of the disease, while the classical operation is related to recurrence of the disease. Also Mesh can reduce the appearing of hematomas, Wound infections after the operation, while the classical operation is related to appearing of the hematomas and Wound infections after the operation. Further more there is no significant difference between the two methods regarding appearing of seromas after the operation however, its appear among those patients which did a classical operation more than those which using mesh for operation. So In our setup Mesh Hernioplasty has proven to be effective with low complication and recurrence rates.
“All-in-one mesh” hernioplasty: A new procedure for primary inguinal hernia open repair
2017
Summary Background We propose a new open mesh hernia repair procedure for the treatment of inguinal hernias in adults aiming to improve patients' comfort and to reduce the incidence of chronic neuralgia. Methods From September 2012 to August 2015, 250 consecutive patients were treated with “all in-one” mesh hernioplasty procedure in our Institution. According to the devised technique, a new smaller prosthesis was placed on the floor of the inguinal canal in order to strengthen all areas of weakness from which hernias may originate. The mesh was enveloped by a fibro-cremasteric sheath avoiding contact with neural structures. Follow-up was carried out at 3, 6, 12, 18 and 24 months for evaluation of postoperative pain using Visual Analogue Scale score, need of medication, patients' comfort and short or long-term complications. Results All patients were discharged within 24 h from surgery. Slight pain was reported by the majority of patients and 47.6% of them did not require pain medication at home. After the 1st postoperative week 96.8% reported no pain and no other symptoms. No relevant limitation of normal activities was reported. There has been no postoperative neuralgia. One recurrence was observed. Conclusions This new hernioplasty technique respects the anatomy of the inguinal canal, uses a smaller mesh, and seems to avoid neuralgia with maximum comfort for the patients.
Surgical options in inguinal hernia: Which is the best
Indian Journal of Surgery, 2006
Background: Inguinal hernia repair in men is one of the most common operations in general surgery. Techniques of surgical repair include open suture, open mesh and laparoscopic techniques. Successful hernia surgery is a series of minimums, specifically minimum risk of surgery and anesthesia, minimum tissue trauma, confinement, complications, cost, disability and recurrence. The most effective surgical treatment is unknown. Materials and Methods: A systemic review of relevant articles on surgical repair of inguinal hernia from National Library of Medicine's Pubmed database along with other available literatures, helped in this review. Conclusion: The recurrence rate from open suture repair may be unacceptably high and postoperative pain and disability is frequent. While the recurrence rate is substantially low with the use of synthetic mesh by both open and laparoscopic method persistent groin pain was a problem though less common following laparoscopic mesh placement. However, laparoscopic repair carry the drawback of a long learning curve (mainly due to unfamiliarity with the pre-peritoneal anatomy), use of general anesthesia, more operative time, cost and some serious though infrequent complications. Having virtually no advantage for adult patients, in the modern day practice open suture repair of inguinal hernia has literally been consigned to the pages of history. It is only recommendable in the repairs of pediatric hernias. The results of mesh repair, both open and laparoscopic are encouraging.
Inguinal hernia: State of the art
A review of the history of inguinal hernia repair from the far surgical approach performed by Celso, trought the physiological reconstruction of inguinal canal by Bassini and the introduction of the concept of tensionfree repair, to the newest find in this specialist surgery. Nowadays in addition to the choice of approach (open vs laparoscopic, anterior vs preperitoneal), the plane where placing the mesh (in front of the trasversalis fascia vs preperitoneal space), and the fixation device (suture vs sutureless vs glue), surgeons can select among a wide range of prosthesis. Choosing the proper biomaterial can determine the success of an operation and prevent biomaterial-related complications. Indepth knowledge and understanding of the physical properties of the pros-thesis, porosity, and pore size in particular are required. Modern advances in hernia repair are credited with reduced recurrence rate, so surgeons' attention is shifted from preventing recurrence to the new topic of chronic pain after surgery.
Journal of Evolution of medical and Dental Sciences, 2014
BACKGROUND: Lichtenstein mesh repair (LMR) and Moloney's darn repair (MDR) are commonly practiced repairs for inguinal hernias with acceptably low recurrence rates. Mesh repair is considered more recent than darn repair and both of them are tension free. AIMS AND OBJECTIVE: To compare operative parameters such as surgical time, hospital stay, cost effectiveness of the procedure and post-operative parameters such as hematoma formation and recurrence between patients undergoing MDR and LMR procedures. MATERIALS AND METHODS: The study was conducted at Department of Surgery, Major S. D. Singh Medical College & Hospital, Farrukhabad from 1st September 2013 to 1st September 2014. A total of 30 patients were selected. 15 patients were treated with MDR (Group 1) and 15 with LMR (Group 2). Cases were followed up for 1, 4, 8 and 16 weeks of discharge. The study design was comparative and prospective. RESULTS: The mean hospital stay was 7.87 days in group 1 and 7.13 days in group 2. The me...
Inguinal Hernia Repair in a Peripheral Hospital
The Professional Medical Journal, 2006
Objective: To know the results of two commonly employed surgical proceduresi.e., Darning and used of Mesh for inguinal hernia repair in adults, considering the cost effectiveness and bettercompliance. Design: Case descriptive study. Place and duration of study: Combined Military Hospital, Chunian - DisttKasur, from November 2004 to April 2006. Patients and Methods: Sixty adult males with the mean age of 48 yearshad inguinal hernia repair. Only two surgical procedure adopted. Group I includes 10 patients (16.3%) who hadprosthetic Mesh repair. Operative time and hospital stay was almost same in both groups. Results: Out of 60 cases,38 patients (63%) had right sided, 19(32%) had left sided and 03(05%) had bilateral inguinal hernia. 42(70%) hadindirect hernia, 17(28.3%) had direct hernia and only 01 patient (1.7%) had both types of hernia. In group-1, 04 patients(8%) had postoperative discomfort in the groin, 02 patients (4%) had scrotal haematoma and 01 patient (2%) hadsuperficial woun...
Evaluation of open hernioplasty in bilateral inguinal hernia repair
2018
Background Inguinal hernia occurs in ∼1.5% of the general population and in 5% of male individuals. The bilateral type affects about 12% of patients, the direct and the combined ones being more frequent than the indirect. Simultaneous or sequential repair has been debated especially after tension-free repairs. Aim This study was carried out to compare Stoppa procedure with bilateral Lichtenstein hernioplasty for the treatment of primary bilateral inguinal hernia. Patients and methods This trial included 80 male patients with primary bilateral inguinal hernias. They were divided randomly into two equal groups. Group A underwent bilateral Lichtenstein hernioplasty and group B underwent Stoppa repair. Preoperative, operative, and postoperative characteristics were recorded for each patient in the study. Patients were followed up at 3, 6, and 12 months postoperatively. Results As regards preoperative data, there was no statistically significant difference between both groups. The Stoppa operation took a significantly shorter time than the bilateral Lichtenstein technique; the mean operative time for Stoppa and bilateral Lichtenstein was 84.0±8.6 and 96.4±6.2 min, respectively. Visual analogue scoring of pain 12 h postoperatively was significantly lower in the Stoppa group than in the bilateral Lichtenstein group. As regards operative and postoperative complications, there was no significant difference between both groups. Hospital stay, return to normal daily activities, and inguinodynia rates were similar in both groups. There was no recorded recurrence in both groups up to 1 year of follow-up. Conclusion Bilateral primary inguinal hernias can be operated upon in one setting without an increase in morbidity or recurrence rate. The Stoppa technique can be a good alternative to bilateral Lichtenstein procedure for the treatment of bilateral inguinal hernia, with comparable outcome.
Prospective Study of Open inguinal Hernioplasty and Short-Term Outcomes
International Journal of Surgical Research, 2013
Inguinal hernia still remains a significant clinical issue and surgeon has to manage. Though, improved surgical techniques and a better understanding of the anatomy and physiology of the inguinal canal have significantly imp roved outcomes for many patients. This study was designed to evaluate the outcomes among hernia patient. Bet ween March 2012 and May 2012, a prospective study of 11 consecutive patients operated for groin hernia using an open preperitoneal tension free mesh technique by a single surgeon was performed in surgical unit, Hospital Universit i Sains Malaysia (HUSM ). The outcome variables being analyzed included time to return to normal activity, pain level, co mplications and recurrence rate. Mean age of the patients was 58.34±14.62 years. Majority of patients (5) had right sided inguinal hernia. Wound infection occurred in 1 patient. No recurrence was observed. Moreover, mild pain were found in 2 patients. A good short-term outcome was found in this study. Lichtenstein's technique of inguinal mesh repair is a safe and effect ive procedure even in co mrobid condition.