A clinical study of inguinal hernia with special reference to laparoscopic trans-abdominal pre peritoneal repair

Abstract

Background:Hernia may be generally defined as the protrusion of an abdominal viscus outside the abdominal cavity through a natural or acquired defect. Latin meaning of the word “hernia” is tear or rupture. A Clinical study on inguinal hernia is undertaken to assess the incidence of inguinal hernia in relation to age, gender and occupation, the different types and modes of clinical presentation of patients, the management of patients with special consideration to laparoscopic (TAPP) repair, to evaluate the operating time, pre-operative and post-operative complications, duration of hospital stay, time taken for recovery, recurrence rate and limitations with respect to laparoscopic TAPP repair.Methods: This is a prospective study of 54 cases of inguinal hernia admitted and underwent surgery for inguinal hernia in Department of General Surgery in Guwahati Medical College and Hospital during the study period of August 2014 to July 2015.Results:The highest number of cases presenting with inguinal hernia were over 45 years and it was more common in males which constituted 96.3 percent of cases. It is more common on right side and indirect hernia is more common than direct hernia. The major possible risk factors are smoking and strenuous work. The commonest presenting mode was swelling followed by swelling with pain. The mean time taken for TAPP was 91.85±15.85 minutes and the median time was 87.50 minutes. There were no intra operative (neurovascular, visceral) complications in any of the patient and there was no conversion to open surgery. There was no mortality in present study and none of the patient had any testicular complication.Conclusions:Laparoscopic hernia repair is associated with steep learning curve for surgeons and is more costly both to patients and health care system in the present scenario. Laparoscopic TAPP hernia repair is found to have encouraging results which is a safe and viable option for repair of inguinal hernia with less postoperative pain and discomfort, improved cosmesis, less post-operative complications and early return to work.

A clinical study on the inguinal hernia and its management in the general surgical practice at tertiary care hospital

“…A study by Rao SS et al, found postoperative complication rate was only 4.92% [5] . A study by Singh S et al, noticed postoperative complication like hematoma in 3.70% cases, seroma in 5.65% cases and infection in 3.70% cases [7] . A study by Prakash S et al, reported wound infection in 11.5% cases, seroma in 2.8% cases and death in 5.7% cases as postoperative complications.…”

“…A study by Singh S et al, reported 57.41% had right side and 38.89% had left side and 3.70% had bilateral hernia. In continue, 62.96% cases had indirect hernia, 35.19% had direct hernia and 1.85% had recurrent hernia [7] . A study by Pulin Ch Kumar and Paul Pratik reported right sided hernias in 66% cases and left sided in 34% cases.…”

“…In the follow up wound infection, hematoma, pain, scrotal swelling, recurrence were noted. [7] . A study by Pulin Ch Kumar and Paul Pratik reported out of 50 hernia cases, majority cases were fall under the age group 50-60 years (30%) and very less number below 20 years [8] .…”

Comparison of self-fixating mesh with conventional polypropylene mesh in lichtenstein’s tension free inguinal hernia repair

“…3 The word hernia is derived from the latin word for rupture. 4 A hernia is defined as a protrusion of a viscus or a part of viscus through an abnormal opening in the wall of its containing cavity. 5 The concept of avoiding tension by on lay mesh repair was introduced by Usher.…”

A Prospective Clinical Study to Evaluate Recurrence and Infection in Laparoscopic Hernia in a Tribal Area

“…The word "hernia" means torn in Latin and branch or bud in Greek 1 . In the medieval era, up to the 19th century, inguinal hernia surgery had poor results.…”