Topic: Inguinal Hernia — Tailored surgery (original) (raw)
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EFFICACY OF MESH REPAIR IN INGUINAL HERNIA AND ITS COMPLICATIONS
A total of 112 patients underwent Mesh repair of 116 inguinal hernia, as 04 patients had bilateral hernias. Inclusion Criteria: Patient with clinical presentation of inguinal Hernia either primary or recurrent in nature. Exclusion Criteria: Patient with other types of groin and extra-groin hernia. Patient, too feeble to withstand surgery. Results: 112 patients were operated on and included in the study. The follow-up period was one-year, the follow-up rate was 75.0%, 83.03% (n: 93) belonged to the urban area, and 16.97% (n = 19) from remote areas. The age of the patients varies from 21 to 70 years. They were all men. With the main percentage of 31.25% (n = 35) in the 21-30 age group. The incidence of this type of hernia was first clinically diagnosed and finally confirmed during surgery. 85 patients (75.89%) had an indirect inguinal hernia and 27 (24.10%) had a direct inguinal hernia. There were no serious intraoperative complications or postoperative death. 36 (32.14%) complications were observed. They were all managed conservatively. Conclusions: Inguinal hernia is very common in men, and Lichtenstein repair can be performed safely, quickly, without stress in surgical departments with excellent results, with low postoperative complications and with very minimal chances of recurrence.
A Study of Postoperative Complications Following Open Mesh Inguinal Hernia Repair
Journal of Evidence Based Medicine and Healthcare, 2016
BACKGROUND Inguinal hernia is the most common type of hernia. Inguinal region consists of deep inguinal ring, inguinal canal and superficial inguinal ring, which make the region weak and susceptible to hernia. 65% of inguinal hernias are indirect hernias and 35% direct hernias. Hernioplasty is the strengthening of posterior wall of inguinal canal. It can be done either with the help of mesh repair or darning. Hernioplasty is indicated in recurrent hernia cases, inguinal hernia with weak abdominal muscle tone where mesh plasty is preferred and inguinal hernia with good muscle tone where darning can be done. In mesh repair, posterior wall (Lichtenstein repair) of inguinal canal is strengthened by a Prolene or Marlex mesh. Over time, fibroblasts and capillaries grow over the mesh converting it into a thick sheath strengthening the posterior wall. Complications which can be encountered postsurgery are pain, bleeding, urinary retention, scrotal swelling, abdominal distension, seroma and wound infections, chronic pain, keloid and testicular atrophy.
Hernia, 2011
Prosthetic reinforcement is the gold standard treatment for inguinal hernia and reduces the risk of recurrence. Yet up to one-third of patients complain of post-surgical pain due to irritation and inflammation caused by the mesh and the fixation materials. Of these patients, 3-4% will experience severe and disabling chronic pain. We performed a prospective multicenter clinical study of a self-adhering prosthesis, consisting of a lightweight polypropylene mesh (40 g/m²) coated on each side with synthetic glue, to evaluate early postoperative complications and patient outcomes. Between August 2008 and June 2010, 186 patients underwent hernia repair using the Lichtenstein technique and the self-adhering prosthesis. Primary endpoints were the frequency of disabling complications and quality of life (QoL) at 3-month follow-up. Pain, numbness, and groin discomfort were evaluated pre- and postoperatively (1 week, 1 and 3 months) using a visual analogue scale (VAS). Patients' pre- and postoperative QoL were measured using the SF12 questionnaire. Secondary endpoints were number of complications and recurrence rate, use of analgesic drugs, length of hospital stay, delay to return to normal activities, and patient satisfaction. The quality of the self-adhering mesh and its clinical utility were also evaluated by the participating surgeons. A total of 186 patients were enrolled and followed for at least 3 months after inguinal hernia repair. A total of 174 (95%) primary hernias and 12 (5%) recurrent hernias were treated. There were no intraoperative complications, no recurrences, and no repeat interventions performed during the study. The post-surgical complication rate was 4.5%. The mean delay to recover normal physical activity was 4 days. For the primary endpoint of pain, a VAS of zero was reported by 93/184 (50.5%) patients at 1 week, 130/171 (76.0%) patients at 1 month and 119/132 (90.2%) patients at 3 months' follow-up (P < 0.0001). The postoperative SF12 scores showed a significant improvement in patient QoL following surgery (P < 0.0001). Adhesix( ® ) self-adhering mesh for prosthetic reinforcement following inguinal hernia repair is atraumatic and associated with infrequent post-surgical complications or pain, a rapid recovery rate, and a high patient-reported QoL. A longer follow-up is underway to assess the frequency of post-surgical recurrence.
Outcome of tension free open mesh repair of inguinal hernia
Journal of Surgical Sciences, 2020
Background: In the practice of General Surgery, hernia repair is the second most common procedure after appendectomy. Several methods have been developed over the years to try to improve hernia repair. Good result can be expected using Bassini's, McVay's, Shouldice's techniques provided the exact nature of hernia is recognized and the repair is done without tension using healthy tissue. The introduction of synthetic mesh started a new era in hernia surgery. The use of synthetic mesh repair of primary and recurrent hernias has gradually gained acceptance among surgeons. Objective: To find out the outcome and complications of open inguinal hernia repair with prolene mesh. Methods: This is a prospective cross sectional study conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from December, 2011 to May, 2012. One hundred patients of inguinal hernia admitted in different surgical units of BSMMU, Dhaka for elective surgery were studied. We have given 1 gm...
Hernia, 2008
Objectives Mild pain lasting for a few days is common following mesh inguinal hernia repair. In some patients however, severe groin pain may appear months or even years postoperatively. The aim of this study was to report our experience of late-onset persisting severe postoperative groin pain occurring years after mesh hernioplasty. Methods In a 9-year period, 1,633 patients (1,073 men), median age 63 years (range 19-88), underwent mesh groin hernia repair. Between 1.5 and 4 years postoperatively, six patients (0.35%) presented with severe chronic groin pain unrelieved by conservative measures and surgical exploration was essential. The patients' records were retrospectively reviewed for the purpose of this study. Results Ilioinguinal nerve entrapment was detected in four patients. The meshes appeared to be indistinguishable from the nerve and were removed along with the stuck nerve. New meshes were properly inserted. Mesh Wxation on the periostium of the pubic tubercle by a staple was found in the other two patients. The staples were removed from the periostium in both patients. Neither hernia recurrence nor chronic groin pain was persisting in all six patients during a follow-up of 6-44 months postoperatively. Conclusion From the results of this study, it appears that ilioinguinal nerve entrapment and/or mesh Wxation on the periostium of the pubic tubercle are the causes of late-onset severe chronic pain after inguinal mesh hernioplasty. Mesh removal, along with the stuck ilioinguinal nerve and staple detachment from the periostium, are the gold-standard techniques if conservative measures fail to reduce pain.
American Surgeon, 2016
To review our experience and outcomes after inguinal hernia repair using the lightweight selfadhering sutureless mesh "Adhesix™" and demonstrate the safety and efficacy of this mesh. This is a 3-year retrospective study that included 143 consecutive patients who underwent 149 inguinal hernia repairs at our department of surgery. All hernias were repaired using a modified Lichtenstein technique. Preoperative, perioperative, and postoperative data were prospectively collected. Incidence of chronic pain, postoperative complications, recurrence, and patient satisfaction were assessed three years postoperatively by conducting a telephone survey. We had 143 patients with a mean age of 58 years (17-84), who underwent 149 hernia repairs using the Adhesix™ mesh. Ninety-two per cent (131 patients) were males. Only 10 patients (7%) had a postoperative pain for more than three years. In our series, neither age nor gender was predictive of postoperative pain. Only one patient had a hematoma lasting for more than one month and only four patients (2.8%) had a recurrence of their hernia within three years of their initial surgery. Ninety per cent of the patient expressed their satisfaction when surveyed three years after their surgery. In conclusion, the use of the self-adhering sutureless mesh for inguinal hernia repair has been proving itself as effective as the traditional mesh. Adhesix™ is associated with low chronic pain rate, recurrence rate, and postoperative complications rate, and can be safely adopted as the sole technique for inguinal hernia repair.
Feasibility of Primary Inguinal Hernia Repair with a New Mesh
World Journal of Surgery, 2006
Background: The purpose of this study was to evaluate the feasibility of primary inguinal repair with open tension-free and sutureless technique using a new polypropylene ''patch and plug system'' (Prolene 3D patch), and the quality of the treatment in terms of reduction of postoperative discomfort. Methods: Fifty-six consecutive patients, mean age 54.5 -11.2 years, with primary unilateral uncomplicated inguinal hernia, were treated in a day-surgery setting. Collected data included: pain scores at 24 hours, 72 hours, and 7, 15, and 30 days after operation, analgesic medications, return to work and to heavy house and/or moderate sporting activities, and quality of life as measured by Short Form 36 health survey questionnaire (SF-36) before the operation and at 6 months follow-up. Results: Postoperative pain was low: the mean visual analog scale (VAS) scores were 2.8 at 24 h, 1.8 at 72 h, and 0.9, 0.3, and 0.04 at 7, 15, and 30 days, respectively. Analgesic drugs were not used by 66.0% (n = 37) of the patients. The mean global time to return to work and to heavy activities was 9.9 -4.6 and 14.6 -7.0, days, respectively. Patient satisfaction showed a significant improvement in all SF-36 domain scores at 6 months follow-up (P < 0.001). There were no major complications, recurrences, or mortality. Conclusions: The new mesh seems to satisfy all requirements of a feasible, reliable, and effective device for repairing primary inguinal hernia with high patient comfort.
Surgery, 2007
Open mesh or non-mesh inguinal hernia repair may influence the incidence of chronic postoperative pain differently. Methods. A total of 300 patients scheduled for repair of a primary unilateral inguinal hernia were randomized to non-mesh or mesh repair. The primary outcome measure was clinical outcome including persistent pain and discomfort interfering with daily activity. Long-term results at 3 years of follow-up have been published. Included here are 10-year follow-up results with respect to pain.
The Use of Self Fixating Mesh in Open Inguinal Hernia Repair
Madridge Journal of Surgery, 2018
Introduction: Lichtenstein technique of inguinal hernia repair, which is performed with tension-free approach by mesh placing and fixation to the surrounding tissues, is currently the treatment of choice for open surgery repair of inguinal hernia. The fixation of the mesh is estimated to be the cause of post-operative complications such as chronic pain, surgical site granuloma, nerve entrapment and hernia recurrence. Aim: The aim of this research is to retrospectively determine the efficacy and the clinical implications underlying the use of self-adhesive mesh compared to a non-adhesive mesh in open surgery repair of inguinal hernia. Methods: This study is a retrospective study that included 248 Patients. These patients underwent open surgery repair for inguinal hernia with Liechtenstein technique at Assuta Hospital, Israel, by using a Progrip adhesive mesh (by Covidien), while fixation was made only with a few Vicryl sutures (2 - 3 stitches only).The Patients were requested to scale pain intensity by using Numerical Rating Scale (NRS) method. For post-operative Clinical evaluation, participants were questioned for periods of one month, three months and six months after surgery while carefully identifying post-operative complications that included chronic pain, surgical wound granuloma, seroma, nerve entrapment and hernia recurrence. Results: The average pain intensity was 3.16 (± 2.3) after one month, 1.14 (± 1.6) after 3 months and 0.43 (± 1.2) after 6 months of surgery. Four patients (2.7%) reported pain intensity over grade 3 on the NRS scale during six months after surgeryand only six patients (4%) reported pain or any discomfort after two years of surgery while the NRS scale was less than 3 during this time. Sixteen patients reported chronic complaints and two patients (0.8%) reported hernia recurrence that led to a second surgery. Conclusion: In conclusion, the use of an adhesive mesh compared to a non-adhesive mesh reduces chronic pain complaints and reduces its severity. In addition, this surgical approach leads to a fewer common post-surgical complications. Nevertheless, there was no change in the incidence of hernia recurrence compared to a non-adhesive mesh.