Abstract
Background: The main aim of the surgeon in inguinal hernia surgery is to lower the recurrence rate while dealing with the defect in inguinal canal. Lichtenstein technique has opened a new era in such repairs. In our study we have evaluated 178 patients who have undergone mesh repair in inguinal hernias by Lichtenstein technique.
Material and Methods: The study was done prospectively from May 2015 to March 2017. Surgery related complications, operative time, hospital stay and return to routine activities were recorded. All the patients with age more than 15 years were included in this study; however patients with medical diseases like diabetes mellitus and chronic obstructive pulmonary disease were not included. Also patients with complications of hernia having features of obstruction or strangulation were also excluded from this study.
Results: Out of 178 patients, 173 patients (97.19%) were male and 05 patients (2.81%) were female. Indirect inguinal hernia was present in 96 patients (53.93%), direct inguinal hernia in 71 (39.89%) and pantaloon hernia in 11 patients (6.18%). The incidence of unilateral hernia was 75.21% whereas bilateral hernia was observed only in 24.78% patients. Postoperative seroma and haematoma was observed in 3 and 1 patient respectively which were drained successfully. None of our patients encountered postoperative neuralgia, wound infection or recurrence till date.
Conclusion: Lichtenstein technique of inguinal hernia repair in adults is still considered as the method of choice by many surgeons around the world in lieu of its simplicity in performing the procedure, minimum postoperative complications, early recovery with return to normal activities, less hospital stay and very low recurrence rate.
Keywords: Lichtenstein technique, Inguinal Hernia Repair, Recurrence.
References
1. Sakorafas GH, Halikias I, Nissotakis C, et al. Open tension free repair of inguinal hernias; the Lichtenstein technique. BMC surgery 2001;1:3.
2. Desarda MP. Physiological repair of inguinal hernia: a new technique (study of 860 patients). Hernia 2006;10:143-146.
3. Desarda MP. No-mesh inguinal hernia repair with continuous absorbable sutures: A dream or reality? (a study of 229 patients). Saudi journal of gastroent-erology: official journal of the Saudi Gastroenterology Association 2008;14:122.
4. Gordon TL. Bassini’s Operation for Inguinal Hernia. British medical journal 1945;2:181.
5. Manyilirah W, Kijjambu S, Upoki A, et al. Comparison of non-mesh (Desarda) and mesh (Lichtenstein) methods for inguinal hernia repair among black African patients: a short-term double-blind RCT. Hernia 2012;16:133-144.
6. Wennström I, Berggren P, Åkerud L, et al. Equal results with laparoscopic and shouldice repairs of primary inguinal hernia in men. Report from a prospective randomised study. Scandinavian Journal of Surgery 2004;93:34-36.
7. Blamey SL, Wale RJ. Laparoscopic repair of inguinal hernia. The Medical journal of Australia 1991;155:718.
8. Lichtenstein IL, Shulman AG. Ambulatory outpatient hernia surgery. Including a new concept, introducing tension-free repair. International surgery 1985;71:1-4.
9. Schultz LS, Graber JN, Pietrafitta J, et al. Early results with laparoscopic inguinal herniorrhaphy are promising. Clinical laser monthly 1990;8:103.
10. Lichtenstein IL, Shulman AG, Amid PK, et al. The tension-free hernioplasty. The American Journal of Surgery 1989;157:188-193.
11. Stoppa R, Petit J, Henry X. Unsutured Dacron prosthesis in groin hernias. International surgery 1975;60:411-412.
12. Usher FC. A new plastic prosthesis for repairing tissue defects of the chest and abdominal wall. The American Journal of Surgery 1959;97:629-633.
13. Usher FC, Fries JG, Ochsner JL, et al. Marlex mesh, a new plastic mesh for replacing tissue defects: II. Clinical studies. AMA archives of surgery 1959;78:138-145.
14. Wantz GE. Giant prosthetic reinforcement of the visceral sac. Surgery, gynecology & obstetrics 1989;169:408-417.
15. Amid PK, Shulman AG, Lichtenstein IL. Open “tension-free” repair of inguinal hernias: the Lichtenstein technique. Eur J Surg 1996;162:447-453.
16. Brown CN, Finch JG. Which mesh for hernia repair? Annals of the royal college of surgeons of England 2010;92:272-278.
17. Klosterhalfen B, Junge K, Klinge U. The light weight and large porous mesh concept for hernia repair. Expert review of medical devices 2005;2:103-117.
18. Amid PK, Lichtenstein IL, Shulman AG, et al. Biomaterials for “tension-free” hernioplasties and principles of their applications. Minerva chirurgica 1995;50:821-826.
19. Morris-Stiff GJ, Hughes LE. The outcomes of nonabsorbable mesh placed within the abdominal cavity: literature review and clinical experience. Journal of the American College of Surgeons 1998;186:352-367.
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.154
