A COMPARATIVE STUDY BETWEEN LICHTENSTEIN’S TENSION FREE HERNIOPLASTY UNDER LOCAL ANAESTHESIA VERSUS MINIMALLY INVASIVE LAPAROSCOPIC APPROACH FOR INGUINAL HERNIAS

Abstract

Inguinal hernia is one of the very common surgery performed all over the world by general surgeons. Despite the frequency of this procedure, no surgeon has ideal results and complications such as post operative pain, nerve injury, infection, and recurrence remain. Over the years ,surgeons all over the world have tried various techniques for repair of inguinal hernias. Each procedure has its own advantages and disadvantages.in recent times the procedure most commonly used to treat adult inguinal hernias is the tension free open hernioplasty using a mesh. however due to recent advances in minimal access surgeries ,laparoscopic hernia surgery is getting common. However unlike laparoscopic cholecystectomy , which was very quickly accepted by surgical community, laparoscopic hernia repair has remained a contentious issue since its inception. This study aimed to compare laparoscopy with open repair under local anaesthesia for inguinal hernia As our institution is new to laparoscopic hernia repair ,I decided to take three times the number of laparoscopic cases as open cases for comparison.so 42 cases of laparoscopic hernia and 126 cases of open hernia under local anaesthesia were taken for study. The duration of surgery, vascular/visceral injury, length of hospital stay, time to normal activities, time to work, immediate post operative pain, chronic pain /paraesthesia, hematoma, seroma and wound infection was analysed. Among the 42 laparoscopic cases,1 was female and 41 were males. Among the 126 open cases,12 was females and 114 were males. Among the cases analysed,61.3% were between the age groups 40-59,21.4% were under 40 years,17.3% were above 60 years. 74.6% 0f open hernia cases took less than an hour and 54.8% of laparoscopic cases took more than an hour to complete one side of procedure. Among the open cases 4 cases had vascular injury,33 cases had chronic pain /paraesthesia over wound site,10 cases had hematoma,9 cases had seroma and 23 cases had wound infection. Among the laparoscopic cases, none had vascular injury, chronic pain and hematoma.1 case of seroma and 2 cases of wound infection was reported Length of hospital stay ,time to resume work and immediate post operative pain was significantly less for laparoscopic group compared to open hernia group. Thus the use of laparoscopic hernia repair resulted in better outcome for the patient