Introduction: Hernia is defined as an abnormal protrusion of a viscus or a part of the viscus through a normal or an abnormal opening in the walls of its containing cavity. The external abdominal hernia is the most common form of spontaneous hernia. The treatment options of hernia should be concerned with prevention of recurrence, prevention of infections and economic considerations. The purpose of this study is to report the observations made in the postoperative follow up of hernia repair by three stitch hernioplasty method, in the Department of general surgery, Thanjavur Medical College, over a period of 2 years.

Materials and Methods: 100 cases of inguinal hernia admitted at Thanjavur Medical College and Hospital during the study period June 2015 to June 2017 who satisfied the inclusion and exclusion criteria were included in the study. For all these patients, the usual Lichtenstein’s repair was not done but a slightly modified procedure, THREE STITCH HERNIOPLASTY was done after getting the consent.

Results: Various factors were analysed like age incidence, sex, side and Postoperative complications observed in this group of patients were in 100 patients studied 12 developed seroma, 4 developed haematoma, 2 developed wound infection, 2 developed chronic groin pain, Only one developed recurrence, none developed foreign body sinus and all the patients returned to work early i.e. before 6 weeks except 2.

Conclusion: The Three Stitch Hernioplasty is a simple method, easy  for the beginners to adopt, has less foreign body reaction, less time consuming, causes less tissue trauma and lesser chance of vascular injury.

Keywords: Three stitch hernioplasty, mesh, seroma, recurrence.

1. Repair of groin hernia with synthetic mesh: meta-analysis of randomized controlled trials. Ann Surg 235:322-332, 2002.
2. Neurnayer La, Gawande AA, Wang J, et aT: Proficiency of surgeons in inguinal hernia repair: Effect of experience and age. Ann Surg 242:344- 348, discussion, 348-352,2005.
3. 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 91:1570-1574,2004.
4. Nienhuijs SW, Boelens OB,Strobbe U: Pain after anterior mesh repair. J Am Coil Surg 200:885-889,2005.
5. Lichtenstein IL, Shulman AG, Amid PK, et al: The tension-free hernioplasty. Am J Surg 157:188-193,1989
6. Janu PG, Sellers KD, Mangiante EC: Recurrent inguinal hernia: Preferred operative approach. Am Surg 64:569-573; discussion. 573 - 574,1998
7. Sirnons MP, Kleijnen J. van Gelciere D, et al: Role of the Shouldice technique in the inguinal hernia repair: A systematic review of controlled trials and a meta-analysis. Br J Surg 83:734-738, 1996.
8. Sabiston’s Textbook of surgery,18^th ‘olume II: pg 1155 1179
9. Schwartz’s Principles of surgery, 9thedition, pg 1305— 1342
10. Mcintosh A, Hutchinson A, Roberts A, et al. Evidence based management of groin hernia in primary care — a systematic review. Farn Pract 2000; 17:442
11. Schumpelick V, Treutner KH, Ant Inguina hernia repair in adults. Lancet 1994;344:375
12. Kang SK, Burnett CA, Freund E, et al. Hernia: is it a work-related condition’? Am J md Med I 999;36:638
13. Tverskoy M, Cozacov C, Ayache M, et al. Postoperative pain after inguinal herniorraphy with different types of anaesthesia. Anesth Anaig 1 990;70:29
14. Klingsworth AN, Britton Bj, Morris Pj. Recurrent inginal hernia after local anesthetic repair. Br J Surg 1982;68:273
15. Lichtenstein IL, Shulman AG, Amid Pk. The cause, prevention and treatment of recurrent groin hernia. Surg Clin North Am 1993;73:529
16. Gilber AT. An anatomic and functional classification for the diagnosis and treatment of inguinal hernia. Am J Surg 1989;157:331
17. Scott NW, Webb K, Go PM, et al. Open mesh versus non-mesh repair of inguinal hernia. Cochrane Database Syst Rev 2001; (4):CD002197
18. Bay- Nielsen M, Kehiet H, Strand L, et al. Quality assessment of 26,304 herniorraphies in Denmark: a prospective nationwide study.
19. Lancet 2001:358:1124
20. Maingot’s Abdominal Operation, Michael J.Zinner, Stanley W. Ashley, eleventh edition pg: 103-120.

Dr N. Mohammed Niyamathullah

Post Graduate, General Surgery, Thanjavur Medical College