Invagination of inguinal hernial sac in comparison with ligation and excision in indirect inguinal hernia

Authors

  • Rahul A. Gupta Department of Surgery, GMERS College, Civil Hospital, Valsad, Gujarat, India
  • Adeesh P. Jain Department of General Surgery, Medical College and SSG Hospital, Vadodara, Gujarat, India
  • Manoj Vasava Department of General Surgery, Medical College and SSG Hospital, Vadodara, Gujarat, India

DOI:

https://doi.org/10.18203/2349-2902.isj20190401

Keywords:

Excision of sac, Hernial sac, Invagination of sac, Indirect inguinal hernia, Postoperative pain

Abstract

Background: To evaluate the incidence of early recurrence and chronic groin pain in the two groups of patients (group A=ligation and excision, group B=invagination) with indirect inguinal hernia and to observe different intraoperative and post-operative parameters in both groups.

Methods: This prospective randomized study was done in SSG Hospital and Government Medical College, Vadodara from 1st December 2016 to 30th November 2017. All the cases of indirect inguinal hernia attending the surgical OPD in SSG hospital were enrolled in this study. All the patients underwent Lichtenstein tension free repair. A total of 50 patients were enrolled in this study. MedCalc Software Version 12.5.0 was used for the analysis of the data and Microsoft word and Excel was used to generate graphs and tables.

Results: 50 patients of indirect inguinal hernia with more than 18 years of age were enrolled and divided into two groups. Intra operative complications, post-operative pain by VAS and post-operative complication observed, which was found insignificant. There was no seroma and induration on both the study group at 3 months and 6 months interval. No local swelling (recurrence) in inguinal region was seen in patients (both group A and group B) during the 6 months follow up period.

Conclusions: This study shows no difference in outcome of results in Lichtenstein tension free hernia repair for indirect inguinal hernia with two different technique in dealing with sac except less postoperative pain in invagination of sac as compare to ligation and excision.

References

Othman I, Hady HA. Hernia sac of indirect inguinal hernia: invagination, excision or ligation?. Hernia. 2014;18(2):199-204.

Col PV, VSM YS, Col CJ, Col MH. Recent trends in dealing with inguinal hernial sac. Med J Armed Forces India. 2003;59(2):108-10.

Gharaibeh KI, Matani YY. To ligate or not to ligate the hernial sac in adults?. Saudi Med J. 2000;21(11):1068-70.

Stylianidis G, Haapamäki MM, Sund M, Nilsson E, Nordin P. Management of the hernial sac in inguinal hernia repair. Brit J Surg: Incorporating Euro J Surg Swiss Surg. 2010;97(3):415-9.

Delikoukos S, Lavant L, Hlias G, Palogos K, Gikas D. The role of hernia sac ligation in postoperative pain in patients with elective tension-free indirect inguinal hernia repair: a prospective randomized study. Hernia. 2007;11(5):425-8.

Ranga HR, Kaushik K, Garg DK, Garg P. The difference in outcomes of excision versus invagination of hernial sac in management of indirect inguinal hernia. J Evol Med Dental Sci-JEMDS. 2016;5(40):2526-9.

Chawla S, Lal P, Ganguly PK, Arora MP, Hadke NS. Endoscope-assisted inguinal hernia repair. JSLS. 2005;9(1):42.

Pancholi M, Sharma P, Patel GR. Retrospective study of inguinal hernia by various methods of surgery. Gujrat Med J. 2012;67(2):22-4.

Campanelli G, Pettinari D, Cavalli M, Avesani EC. Inguinal hernia recurrence: classification and approach. J Minim Access Surg. 2006;2(3):147-50.

Merskey H. International association for the study of pain (IASP): subcommittee on taxonomy, classification of chronic pain, description of pain terms. Pain. 1986;3.

PPM. Practical pain management. pain assessment: review of current tools by Arbuck DM, Fleming A., 2017.

Wall PD, Melzack R. Textbook of pain. 4th ed. Churchil-livingstone: edinburg; 1999.

Loos MJ, Houterman S, Scheltinga MR, Roumen RM. Evaluating post herniorrhaphy groin pain: visual analogue or verbal rating scale?. Hernia. 2008;12(2):147-51.

Robbins AW, Rutkow IM. Open mesh plug hernioplasty: the less invasive procedure. Surg Tech Inter. 1996;5:87.

Lichtenstein IL, Sulman AG, Parviz K. Amid. The tension free repair of groin hernias. In: Nyhus, Lloyd M. Robert. E. Condon, eds. Hernia. 4th ed. Philadelphia: Lippincott; 1995: 237-249.

Rutkow IM, Robbin AW. Open mesh plug hernioplasty. Prob Gen Surg. 1995;12:121-7.

Downloads

Published

2019-01-28

Issue

Section

Original Research Articles