Short Term Pain and Return to Activities Following Lichtenstein Inguinal Hernia Repair

Abstract

IntroductionThere has been extensive debate as to the merits of laparoscopic versus Lichtenstein hernia repair. Laparoscopic results have claimed less postoperative pain and more rapid return to normal activity. This study assesses the short-term results of a dedicated experienced hernia surgeon who uses the Lichtenstein technique with local anaesthesia and light sedation almost exclusively. It analyses post-operative pain, recovery, and return to normal activities and work.MethodologyThere were two study arms. The first was a randomly selected cohort of patients (n=405) who underwent single, bilateral or recurrent hernia repair from 2006 to 2008 by a single surgeon. The second was a prospective consecutive cohort (n=54) from 2010 who were stratified according to normal activity. Postoperative analgesia requirements, pain, and time of return to activities were recorded.ResultsIn cohort 1, return to work took a median of 6 days. Seventy-five per cent of patients were back to their normal activities and duties after 10 days. The median analgesia requirement was 2 days. In cohort 2, the median postoperative analgesia requirement was 3 days, with 75% requiring analgesia for no more than 6 days. The median return to normal activities or work was seven days, with 75% returning before 2 weeks. ConclusionLHR provides favourable short-term outcomes. Considering that convalescence is short or shorter and the rate of serious complications is low, this technique should be advocated more vigorously.