Background The open preperitoneal approach in inguinal hernia repair might have the benefit of a mesh in the preferred space without the disadvantages of an endoscopic procedure. Methods A total of 172 patients with primary inguinal hernia were randomized to undergo the open preperitoneal Kugel or the standard open anterior Lichtenstein procedure in a teaching hospital. The main outcome measures were operating variables, visual analog scale (VAS) pain scores, and consumed analgesics during the first 2 weeks postoperatively and at 3 months, neurological examination, and complications.
The PDI is feasible in inguinal hernia repair and can be used as an adjuvant in pain measurement. It can identify patients still suffering postoperatively who might otherwise be missed. Furthermore, the PDI could serve as a predictor for chronic pain.
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