Comparison between minimal stitch hernioplasty and continuous suturing of mesh in inguinal hernia repair: a randomised controlled trial

Authors

  • Vidhya Sree S. Department of General Surgery, ESIC Medical College & PGIMSR, Chennai, Tamil Nadu, India
  • Sandhya Palit Department of General Surgery, ESIC Medical College & PGIMSR, Chennai, Tamil Nadu, India
  • Bhanumati Giridharan Department of General Surgery, ESIC Medical College & PGIMSR, Chennai, Tamil Nadu, India
  • Dinesh M. Department of General Surgery, ESIC Medical College & PGIMSR, Chennai, Tamil Nadu, India
  • Balasubramanian A. Department of General Surgery, ESIC Medical College & PGIMSR, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-2902.isj20232324

Keywords:

Inguinal hernia, Minimal stitch, Continuous suturing, Pain score

Abstract

Background: Inguinal hernia repair is the most commonly done surgery of all general surgical procedures. Hence in an attempt to decrease the pain and increase the patient’s comfort, various techniques have been considered to fix the mesh. The aim of this study was to compare the differences between the two techniques of mesh fixation namely the minimal stitch method and the continuous suturing in terms of various parameters.

Methods: This study was conducted selecting 126 patients who attended the general surgery OPD at ESIC MC and PGIMSR and randomly allocating them to the two study groups; the patients were followed up till 6 months post-operatively. The parameters taken into account were: the operative time, the duration of hospital stay, the pain scores at various time intervals (POD 1, 3, 7, 30, 60, 90, 180) and the incidence of complications if any.

Results: Among the 126 male patients enrolled in the study, the highest % belonged to the age group 51-60. 90% of them had unilateral hernias. The pain scores were significantly low in the minimal stitch group from the first postoperative day up to 1 month. The operative time and duration of hospital stay was also significantly decreased in the minimal stitch group.

Conclusions: Hence, the minimal stitch technique used for inguinal hernia repair in our study proved to be comparable to the conventional suturing, better than the latter in terms of patients’ subjective satisfactory factors such as less operative time and less hospital stay while having no significant difference in terms of occurrence of chronic inguinodynia or any other postoperative complications.

References

Vijayakumar S., Alagar SR. A Study on incidence and risk factors of inguinal hernia in ESI Population. IOSR-JDMS. 2016;15(7):32-4.

Chow A, Purkayastha S, Athanasiou T, Tekkis P, Darzi A. Inguinal hernia. BMJ Clin Evid. 2007;4:1-20.

Baylón K, Rodríguez-Camarillo P, Elías-Zúñiga A, Díaz-Elizondo JA, Gilkerson R, Lozano K. Past, Present and Future of Surgical Meshes: A Review. Membranes. 2017;7(47):23-9.

Kapur N, Kumar N. Incidence of chronic pain after single stitch mesh fixation in open inguinal hernia repair: An observational prospective study, a case series. Int J Surg. 2017;8:32-5.

Shirah BH, Shirah HA. Lichtenstein mesh hernioplasty for inguinal hernias: simplicity is the ultimate sophistication. Int Surg J. 2016;3(1):230e6.

O'Dwyer PJ, Norrie J, Alani A, Walker A, Duffy F, Horgan P. Observation or operation for patients with an asymptomatic inguinal hernia. Ann Surg. 2006;244: 167-73.

Yilmaz B, Ilker A. The search for ideal hernia repair; mesh materials and types. Int J Surg. 2012;10:317-21.

Shirah BH, Shirah HA. Lichtenstein mesh hernioplasty for inguinal hernias: simplicity is the ultimate sophistication. Int Surg J. 2016;3(1):230-6.

Neumayer La, Gawande AA, Wang J. Proficiency of surgeons in inguinal hernia repair: Effect of experience and age. Ann Surg. 2005;242:344-8.

Grant AM, Scott NW, O’Dwyer PJ: Five – year follow – up of a randomized trial to assess pain and numbness after laparoscopic or open repair of groin hernia. Br J Surg. 2004;91:1570-4.

Nienhuijs SW, Boelens OB, Strobbe LJ: Pain after anterior mesh repair. J Am Coll Surg. 2005;200:885-9.

Sabiston A. Textbook of surgery. 18th ed. USA: Springer; 2007:2;1155-79.

McIntosh A, Hutchinson A, Roberts A. Evidence based management of groin hernia in primary care: a systematic review. Fam Pract. 2000;17:442.

Gilber AI. An anatomic and functional classification for the diagnosis and treatment of inguinal hernia. Am J Surg. 1989;157:331.

Bay- Nielsen M, Kehlet H, Strand L. Quality assessment of 26,304 herniorraphies in Denmark: a prospective nationwide study. Lancet. 2001:358:1124.

Downloads

Published

2023-07-28

Issue

Section

Original Research Articles