Clinical outcomes of lichtenstein's tension-free inguinal hernioplasty under local anesthesia: A prospective study.

Jaspreet Singh  Bedi; Prabhdeep Singh  Chowdhary; Saibal Kumar  Mukherjee; Hiranmay  Bhattacharya; Sarfaraz  Nawaz; Aditya  Anand

doi:10.51168/sjhrafrica.v6i6.1861

Authors

Jaspreet Singh Bedi Postgraduate Trainee, Department of General Surgery, MGMMC and LSK Hospital, Kishanganj, Bihar, India
Prabhdeep Singh Chowdhary Postgraduate Trainee, Department of General Surgery, MGMMC and LSK Hospital, Kishanganj, Bihar, India
Saibal Kumar Mukherjee Professor, Department of General Surgery, MGMMC and LSK Hospital, Kishanganj, Bihar, India
Hiranmay Bhattacharya Professor, Department of General Surgery, MGMMC and LSK Hospital, Kishanganj, Bihar, India
Sarfaraz Nawaz Assistant Professor, Department of General Surgery, MGMMC and LSK Hospital, Kishanganj, Bihar, India
Aditya Anand Assistant Professor, Department of General Surgery, MGMMC and LSK Hospital, Kishanganj, Bihar, India

DOI:

https://doi.org/10.51168/sjhrafrica.v6i6.1861

Keywords:

Local anesthesia, Lichtenstein repair, inguinal hernia, inguinal hernioplasty

Abstract

Background

A portion of a viscus protruding through the inguinal canal is commonly referred to as an inguinal hernia. Types of hernias that are inguinal, that is, either direct or indirect, were distinguished by Casper Stromayr in 1559. However, in terms of contemporary surgical biology, hernia of the inguinal is termed to be useless in terms of direct or indirect distinction because only traction or removal of the inferior epigastric arteries can change one into the other.

Objectives

The purpose of the study was to evaluate the clinical results of local anesthesia-assisted Lichtenstein's tension-free inguinal hernioplasty.

Materials and Methods

A prospective investigation was conducted. At the Mata Gujri Memorial Medical College and Lions Seva Kendra Hospital, Kishanganj, Bihar, India, the study was carried out. It has been conducted for 18 months. A total of sixty patients were included in the research. Participants in the study were chosen from the General Surgery Outpatient Department's inguinal hernia wards. Not all instances of strangulated and blocked hernias were included.

Results

Four patients (6.67%) had retention or urine, two patients (3.33%) had infection, four patients (6.67%) had seroma, one patient (1.67%) had hematoma, two patients (3.33%) had scrotal enlargement, and two patients (3.33%) had induration. A visual analog scale was used to carefully assess pain severity and classify it as mild, if the score ranges between 0 to 3, moderate if the score ranges between 4 to 5, and severe if the score ranges from 6–10.

Conclusion

According to the study's findings, the techniques used for tension-free Lichtenstein's inguinal hernioplasty under anesthesia that is local are safe, easy, cost-effective, and devoid of adverse effects such as spinal headaches, nausea, vomiting, hypotension, and retention of urine.

Recommendations

Future research may also be carried out to clarify the results for a larger population.

References

Read RC. Collagen Synthesis and Direct Inguinal Herniation. Surgical Laparoscopy Endoscopy & Percutaneous Techniques. 1994 Oct 1;4(5):392.https://doi.org/10.1097/00019509-199410000-00027

Read RC. Attenuation of the rectus sheath in inguinal herniation. The American Journal of Surgery. 1970 Nov 1;120(5):610-4.https://doi.org/10.1016/S0002-9610(70)80178-7PMid:4249908

Ponka JL. The relaxing incision in hernia repair. The American Journal of Surgery. 1968 Apr 1;115(4):552-7.

https://doi.org/10.1016/0002-9610(68)90203-1PMid:4230621

Berliner SD. An approach to groin hernia. The Surgical Clinics of North America. 1984 Apr 1;64(2):197-213.

https://doi.org/10.1016/S0039-6109(16)43279-2PMid:6233731

Zinner MJ, Schwartz SI, Ellis H. Maingot's abdominal operations. Journal of the American College of Surgeons. 1997;3(185):307.https://doi.org/10.1016/S1072-7515(98)80006-9

Ponka JL. Hernias of the abdominal wall. In Hernias of the abdominal wall 1980 (pp. 644-644).

Wantz GE. Complications of inguinal hernial repair. The Surgical Clinics of North America. 1984 Apr 1;64(2):287-98.

https://doi.org/10.1016/S0039-6109(16)43285-8PMid:6729670

Callesen T, Bech K, Kehlet H. One-thousand consecutive inguinal hernia repairs under unmonitored local anesthesia. Anesthesia & Analgesia. 2001 Dec 1;93(6):1373-6.https://doi.org/10.1097/00000539-200112000-00004

PMid:11726409

Amid PK, Shulman AG, Lichtenstein IL. Simultaneous repair of bilateral inguinal hernias under local anesthesia. Annals of Surgery. 1996 Mar 1;223(3):249-52.https://doi.org/10.1097/00000658-199603000-00004 PMid:8604904 PMCid:PMC1235112

Glassow F. Inguinal hernia repair using local anaesthesia. Annals of the royal college of surgeons of England. 1984 Nov;66(6):382.

AJ M. Inguinal hernia. A three-year review of two thousand cases. The British Journal of Surgery. 1962 Jan 1; 49:384-94.

https://doi.org/10.1002/bjs.18004921607PMid:14470215

MacFadyen Jr BV, Mathis CR. Inguinal herniorrhaphy: complications and recurrences. InSeminars in Laparoscopic Surgery 1994 Jun (Vol. 1, No. 2, pp. 128-140). Sage CA: Thousand Oaks, CA: Sage Publications.

https://doi.org/10.1177/155335069400100208

Morris GE, Jarrett PE. Recurrence rates following local anaesthetic day case inguinal hernia repair by junior surgeons in a district general hospital. Annals of The Royal College of Surgeons of England. 1987 May;69(3):97.

Zimmerman LM. Recurrent inguinal hernia: Surg Clin North Am. 1971;51:1317-24.https://doi.org/10.1016/S0039-6109(16)39585-8 PMid:4256968.