Comparative Study of Stoppa’s Repair by Pfannensteil Incision Versus Lichtenstein Technique for Management of Bilateral Inguinal Hernia

Title: Comparative Study of Stoppa’s Repair by Pfannensteil Incision Versus Lichtenstein Technique for Management of Bilateral Inguinal Hernia

Authors: Dr Pragnesh Gavit, Dr Amul Bhedi, Dr Sushil Damor, Dr Arnab Sarkar

DOI: https://dx.doi.org/10.18535/jmscr/v5i1.41

Abstract

Background: Hernia repair is one of the most commonly performed general surgical procedures worldwide. Today, Stoppa’s repair has been considered as an alternative to Lichtenstein’s tension free mesh hernioplasty in the case of bilateral inguinal hernias. This new technique is theoretically closer to ideal hernia repair and based on the concept of providing a strong, mobile and physiologically dynamic posterior inguinal wall. The technique is simple, easy to learn and does not require complicated dissection or suturing.

Aims and Objectives: To establish the influence of Stoppa’s repair on early clinical outcomes of bilateral inguinal hernia repair and limited study of long term outcomes, especially with regards to post-operative pain, operative time, wound complications, recurrence, time taken to ambulate etc.

Settings and Design: This is a comparative study carried out in 60 patients, out of which 30 underwent Lichtenstein’s repair and 30 underwent Stoppa’s repair, admitted in surgical ward in Sir Sayajirao Hospital, Baroda from October 2014 to November 2016.

Materials and Methods: Data was collected by meticulous history taking, careful clinical examination, appropriate radiological, haematological investigation, operative findings and follow-up of the cases.

Results: Post-operative pain relief was more in Stoppa’s group compared to Lichtenstein group on day 1, 3 and 7. Also, early and late wound complications were lesser in Stoppa’s group compared to Lichtenstein’s group. Patients of Stoppa’s group returned to routine work faster compared to Lichtenstein group. Chronic groin pain was found to be less incident in Stoppa’s group, but that was not statistically significant due to the limited follow-up period. There was no recurrence seen in both groups during the 6 months follow-up period.

Conclusion: It can be reliably concluded that Stoppa’s repair using pfannensteil incision is definitely a promising procedure for the management of patients with bilateral inguinal hernias.

Keywords: Stoppa’s repair, Lichtenstein’s meshplasty, Inguinal hernia, Postoperative Pain, Hernioplasty.

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