Minimal postoperative pain using properitoneal nontension sutured repair of direct inguinal hernias

American Journal of Surgery
Mark T NutleyNeil Hagen

Abstract

Numerous repairs exist for direct inguinal hernias. These repairs are limited by the shortcomings of their respective technique. Reported recurrence rates for all currently employed hernia repairs for direct inguinal hernias range from 1% to 10%. With recurrence rates for nontension mesh repairs <2%, the evaluation of postoperative outcomes has shifted instead to that of pain and return to normal activities. We describe a novel inexpensive technique that employs the placement of conventional properitoneal tension-free mesh for repair of direct inguinal hernia. This technique, performed as day surgery with the patient under local anaesthetic, offers the beneficial aspects of contemporary mesh repair while avoiding its limitations. Three-year independent follow-up of 52 patients undergoing this repair demonstrated 1 (1.9%) early failure. Postoperative pain was measured using a visual analog pain scale (0 to 10) at 2 months (mean +/- SD; 1.39 +/- .58), 1 year (.37 +/- .27), 3 years (.58 +/- .40), at work (.59 +/- .33), and with recreational activity (.73 +/- .40). More than one third of patients had returned to work 1 week after surgery (37.8%) with 62.2% returning by 2 weeks and 100% by 6 weeks. Most significantly, 90.9% of patie...Continue Reading

References

Jul 1, 1990·American Journal of Surgery
Dec 14, 1999·The British Journal of Surgery·T CallesenH Kehlet
Aug 10, 2000·The British Journal of Surgery·UNKNOWN EU Hernia Trialists Collaboration
Aug 10, 2000·The British Journal of Surgery·UNKNOWN EU Hernia Trialists Collaboration
Jan 7, 2003·The Clinical Journal of Pain·Amudha S PoobalanW Alastair Chambers

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Citations

Dec 29, 2009·Surgery Today·Mark Berner HansenMichael Edward Crawford
Sep 8, 2007·Hernia : the Journal of Hernias and Abdominal Wall Surgery·E P PélissierO Monek

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