Repair of a Primary Inguinal Herniaby Using a Polypropylene Mesh:A Tension Free Lichtenstein Repairin Rural Andhra Pradesh

摘要

Introduction: Inguinal hernia repair is one of the most commonly performed surgeries in the world. Inguinal hernia accounts for 75% of all the abdominal wall hernias, with a life time risk of 27% in men and 3% in women (1). The recurrences which follow inguinal hernia repair are of a significant problem. As the pathogenesis of adult inguinal hernia is a defect in the metabolism of collagen, leading to a weakening in the fascia transversalis, the use of such a weakened tissue is problematic for the hernia repair. This study was conducted in the Konaseema Institute of Medical Sciences, Amalapuram, in a rural area of Andhra Pradesh, to determine the usefulness of a polypropylene mesh for tension free repair in terms of patient comfort, affordability, return to normal activity and post operative follow up. Materials and Methods: A prospective study was conducted from April 2008-March 2009, with a follow up of 2 years, for recurrence and any other morbidity.100 Lichtsenstein tension free hernioplasties for inguinal hernia were performed by using a polypropylene mesh between. Results: The inguinal hernia was right sided in 54 cases and 28 cases had left sided hernia, while 18 were bilateral hernias. Out of these, 57 were indirect and 43 were direct hernias. The average duration of the surgery was 45 minutes, the duration of the stay in the hospital was 4 days and after a follow up for 2 years, there was no evidence of recurrence, post-operative neuralgia, delayed rejection of the mesh or testicular swelling. 2 cases had superficial wound infections. Conclusion: Lichtenstein tension free repair with a prolene mesh is an excellent approach in the management of inguinal hernia, with encouraging results in places where Laparoscopic TEP and TAPP are not within the reach of most of the patients in terms of affordability.