Classic groin hernia repair…lest we forget

Comparative Study of Self-Gripping Mesh vs. Polypropylene Mesh in Lichtenstein's Open Inguinal Hernioplasty

Background Inguinal hernia is one of the most common conditions in India, and history has many repair techniques recorded in it. Postoperative pain still remains a problem despite tension-free hernioplasty being accepted as the gold standard. Increased duration of surgery not only exposes the patient to unwanted increased chances of mesh infection but also reduces the surgeon's productivity if continued persistently. In this study, the main aim was to compare the fixation techniques of polypropylene mesh vs. self-gripping mesh in inguinal hernia surgery in terms of duration of surgery, postoperative pain, seroma, recurrence, foreign body sensation, and wound infections. Methods It is a prospective, comparative, and quantitative study conducted at Sri Ramachandra Institute of Higher Education and Research in the Department of General Surgery. Patients presenting with inguinal hernia to the OPD were included in the study. The sampling technique used in this study is simple, convenient sampling. As a result, the calculation of the margin of error and confidence levels may be difficult. Nevertheless, the sample accurately represents the population. Patients were divided into two groups: the study group (25), patients undergoing hernioplasty with self-gripping mesh, and the control group (25), patients undergoing hernioplasty with polypropylene mesh using conventional suturing. The duration of surgery, postoperative pain, seroma, recurrence, foreign body sensation, and wound infections were compared and analyzed between the two groups. Results In this study, the duration of surgery was less than one hour for three patients (12%) in the control group (polypropylene), compared to 13 (52%) patients in the study group (self-gripping), which is statistically significant. The early postoperative pain on POD 0 was greater than 4 (visual analogue score) in 8 (32%) patients in the control group and two (8%) patients in the study group. There were no significant differences in chronic pain, recurrence rate, seroma rate, or wound infection between the two groups. Conclusions In our study, we conclude that self-gripping mesh is superior to polypropylene mesh in surgery of inguinal hernia in terms of shorter duration of surgery. There is also reduced pain in the immediate postoperative period though not statistically significant. There is no significant difference in both the groups in terms of seroma formation, wound infection, foreign body sensation, and recurrence.

Comparison of prolene and progrip meshes in inguinal hernia repair in terms of post-operative pain, limitation of movement and quality of life

Objectives

The study aimed to compare the techniques applying prolene mesh and progrip-self fixating mesh in terms of post-operative pain, limitation of movement and quality of life.

Material and Methods

The study was conducted from November 2014 to January 2016 in Department of Surgery, Manisa Celal Bayar University Hospital. The study recruited 50 male patients, aged 18 and over and was carried out as a double blinded procedure. Twenty-five patients were randomly selected to receive hernia repair by progrip self-fixating mesh and 25 patients were treated with hernia repair with suture fixation method by using prolene grafts, and patients' pain follow-up was performed with face-to-face or telephone interviews with VAS (Visual Analogue Scale) and return to daily routine activities were evaluated with SF-36 (Short Form-36) quality of life scale. Recurrent hernias and emergency cases were excluded.

Results

The pain scores were lower and a statistically significant difference was achieved in patients in whom progrip self-fixating mesh was used in the early postoperative period. Both methods gave statistically similar results in terms of pain and quality of life.

Conclusion

In the literature, there are some evidence that the repair applied with progrip self-fixating graft has more positive outcomes compared to the repairs applied with suture fixation. It is concluded that there is a need for longer follow-ups and larger series of cases in order to achieve a definite result.

Inguinal Hernia: Mastering the Anatomy

The success of an inguinal hernia repair is defined by the permanence of the operation while creating the fewest complications at minimal cost and allowing patients an early return to activity. This success relies and depends on the surgeon's knowledge and understanding of groin anatomy and physiology. This article reviews relevant anatomy to inguinal hernia repair and technical steps to open tissue and mesh repairs as well as minimally invasive approaches.

Sports hernia treatment: modified bassini versus minimal repair

Background:

The minimal repair technique for sports hernias repairs only the weak area of the posterior abdominal wall along with decompressing the genitofemoral nerve. This technique has been shown to return athletes to competition rapidly. This study compares the clinical outcomes of the minimal repair technique with the traditional modified Bassini repair.

Hypothesis:

Athletes undergoing the minimal repair technique for a sports hernia would return to play more rapidly compared with athletes undergoing the traditional modified Bassini repair.

Methods:

A retrospective study of 28 patients who underwent sports hernia repair at the authors’ institution was performed. Fourteen patients underwent the modified Bassini repair, and a second group of 14 patients underwent the minimal repair technique. The 2 groups were compared with respect to time to return to sport, return to original level of competition, and clinical outcomes.

Results:

Patients in the minimal repair group returned to sports at a median of 5.6 weeks (range, 4-8 weeks), which was significantly faster compared with the modified Bassini repair group, with a median return of 25.8 weeks (range, 4-112 weeks; P = 0.002). Thirteen of 14 patients in the minimal repair group returned to sports at their previous level, while 9 of 14 patients in the Bassini group were able to return to their previous level of sport (P = 0.01). Two patients in each group had recurrent groin pain. One patient in the minimal repair group underwent revision hernia surgery for recurrent pain, while 1 patient in the Bassini group underwent hip arthroscopy for symptomatic hip pain.

Conclusion:

The minimal repair technique allows athletes with sports hernias to return to play faster than patients treated with the modified Bassini.