Background: The repair of inguinoscrotal hernias is a very
commonly performed operation in surgical units worldwide. There is still no
gold standard for the operative management of groin hernias despite a myriad of
techniques available. The open technique of groin hernia repair
both anteriorly as well as posteriorly with a tension free mesh has decreased
the occurrence of the postoperative pain as well as recurrence. The Lichtenstein
tension free mesh hernioplasty has gained the position of reference technique
in open groin hernia repairs. Chronic pain is the main postoperative
complication in inguinal hernia repair after Lichtenstein's repair.
Aim: To decrease postoperative pain,
the use of a mesh which is placed in
study comprised of 120 consecutive adult patients who were fulfilling the
inclusion criteria and treated with the trans-inguinal pre-peritoneal (TIPP)
technique by the same surgical team.. The primary endpoint was the early
post-operative pain and the objectivity of pain was assessed by visual analogue
scale (VAS) 24 hours post-operatively and the secondary endpoint was the
hospitals stay measured in days.
Results: Out of
120 Patients, 119 patients (99.2%) were male and only 1 patient (0.8%) was
female with their mean age of 43.12, SD ±16.184 years. 49 patients (40.8%) were
having left sided unilateral inguinal hernias while 71 patients (59.2%) having
right sided unilateral inguinal hernias. 20 patients (16.7%) were diagnosed as having
direct inguinal hernias while 100 patients (83.3%) were having indirect
inguinal hernias, Mean VAS score at 24 hours post-operatively was noted as
3.73, SD ±1.442 with maximum VAS pain score 8 and minimum score 2, while the mean hospital stay in all the
patients post-operatively was found to be as 1.27 days, SD ±0.24 days. None of
the patients developed wound infection, 3 patients developed seroma formation
which were managed conservatively.
Conclusions: The open preperitoneal hernia repair (Trans-inguinal pre-peritoneal mesh
repair) is safe, feasible and effective technique. With this approach, there is
reduced early post-operative pain and the hospital stay.
Pre-peritoneal, Mesh plasty (Mesh hernioplasty).