Title: An Innovative Tehnique for Inguinal Hernia Repair under Local Anasthesia as Ambulatory Surgery
Author: Bhavinder Arora
DOI: http://dx.doi.org/10.18535/jmscr/v4i3.34
Abstract
Introduction:The Lichtenstein technique of meshplasty has pioneered the ambulatory surgery for inguinal hernia repair with standard way of securing the mesh in position on the posterior wall of inguinal canal is with polypropylene sutures.
Methods:A total of 50 cases were operated under local anaesthesia for inguinal hernia as day surgery or ambulatory surgery with three stitch mesh anchoring technique.
Results:We observe the mean operative time was 29.3+8.5 minutes. Whereas 70 % were pain free with local anesthesia only. Only 20 % of the patients complained of Post-op pain. Two patients developed hematoma and Seroma. Three patients developed wound site induration and infection. Only one patient stayed for 48 hrs that to due to complications.
Conclusion:We conclude that three stitch mesh anchoring technique for inguinal hernia repair under local anesthesia is easy to learn and faster with less post-operative complication and early ambulation.
Key Words: Meshplasty, Ambulatory Surgery, Local Anesthesia, Inguinal Hernia.
References
1. Desarda MP. Surgical physiology of inguinal hernia repair. B.M.C. Surgery 2003: 2482-2532.
2. Lichenstein IL, Shulman AG, Amid PK. The tension free hernioplasty. Am J Surg. 1989; 157:188-193.
3. Doctor HG. Skin stapler in Lichtenstein’s Mesh Repair. Indian J Surg 2005; 67(4):225.
4. Garg CP, Bhatnagar AM, Parmar CD, Darshan JR, Sehgal RA. Comparative study of skin staples and polypropylene sutures for securing the mesh in lichtenstein’s tension free inguinal hernia repair: A Prospective randomized controlled clinical trial. Indian J Surg 2004; 66(3):152-155.
5. Chauhan A. Use of skin stapler in lichenstein’s mesh repair (letter to editor). Indian J Surg 2005;67(1):66.
6. Chawla S, Lal P, Ganguly PK, Arora MP, Hadke NS. Endoscope-Assisted Inguinal Hernia repair. JSLS. 2005 Jan-Mar; 9(1):42-46.
7. Mixter C. A cost utility analysis of treatment options for inguinal hernia in 1,513,008 adult patients. Surgical Endoscopy. 2004; 18(10):1541-1541.
8. Kulacoglu H, Alptekin . Current options in local anesthesia for groin hernia repairs. ACI Vol. LVIII:25-34.
9. Metzger J, Lutz N, Laidlaw I. Guidelines for inguinal hernia repair in everyday practice. Ann R CollSurg Engl. 2001;83:209-214.
10. Chyung JW, Shin DG, Kwon Y, Cho DH, Lee KB, Park SS et al. Tumescent local anesthetic technique for inguinal hernia repairs. Ann Surg Treat Res. 2014 Dec; 87(6):325-330.
11. Amid PK, Shulman AG, Lichenstein IL. Simultaneous repair of bilateral inguinal hernias under local anesthesia. Ann Surg. 1996 Mar; 223(3):249-252.
12. Callesen T, Bech K, Hesselfeldt P, Andersen J, Nielsen R, Roikjaer O, Kehlet H. Recurrence of inguinal hernia: ambulatory surgery under local anesthesia. Ugeskr Laeger. 1996 Dec; 158(49):7057-60.
13. JacquetE,Puche P, Alahyane J, JaberS,Carabalona JP, Bessaou D, et al Evaluation of inguinal hernia in ambulatory surgery: A prospective monocentric study on 1009 inguinal hernia. Ambulatory Surgery; 2006 Jul;12( 4):167–171.
14. O'Dwyer PJ, Serpell MG, Millar K, Paterson C, Young D, Hair A, et al. Local or general anesthesia for open hernia repair: a randomized trial. Ann Surg. 2003 Apr; 237(4):574-579.
15. Nordin P, Haapaniemi S, Linden WD, Choice of Anesthesiaand Risk of Reoperation for recurrence in Groin Hernia Repair. Ann Surg. 2004 Jul; 240(1):187–192.
16. Ella AA, Atrebi MAE. Comparing skin staples to sutures for fixing mesh in tension free hernioplasty. Med J Cairo Univ 2015 March; Vol 83(1): p23-26.
17. Arora BK. Three stitch inguinal hernia meshplasty under local anesthesia: Ambulatory surgery. Day Surg J India 2012; 7: 29-31.