Mesh Repair Of Inguinal Hernia Research Articles

Evaluation of Desarda technique in inguinal hernia repair

Background: Mesh repair for inguinal hernia is the most commonly carried out procedure spherical the world. In recent years inguinal hernia surgery has gone through numerous advances. Desarda technique offers a new thought of hernia repair based on physiological principle that uses an undetached strip of external oblique aponeurosis which gives a complete understanding about basic aetiopathology of inguinal hernia. The aim of this study was to evaluate inguinal hernia repair by Desarda technique. Methods: This observational study was carried out at the department of surgery, Mugda medical college hospital included 50 male patients with uncomplicated inguinal hernia during August 2019 to July 2021. Data was collected by researcher himself with using a prepared structured questionnaires & checklist and analyzed on statistical packages for social science (SPSS) 24. Results: Among 50 male patients 60% belong to low-income status, mean age was 44.09±10.93 years. The mean operative time was 46.31±12.27 mins. In the first postoperative day 22 patients reported mild pain and on third postoperative day majority (42) reported no pain. The mean duration of hospital stay was 18.16±11.24 hours. No severe postoperative complication, one recurrence was reported. The mean time of return to basic activities 2.3±1.33 days. Conclusions: The results of inguinal hernia treatment with the Desarda technique are similar to the results after standard Lichtenstein operations. Patients after Desarda's operative procedure get ambulatory sooner as compared to the standard Lichtenstein mesh repair. Less Postoperative pain, complications similar to standardized technique.

Feasibility and safety of redo laparoscopic repair of recurrent inguinal hernia following previous endolaparoscopic repair.

Laparoscopic redo inguinal hernia (LRIH) repairs are fraught with challenges as the pre-peritoneal space is violated due to previous surgery and the presence of mesh. The purpose of this study was to present the feasibility and safety of LRIH in a series of patients with recurrent inguinal hernia following previous endolaparoscopic repair and present technical experiences and clinical outcomes in this subset of patients. This was a retrospective study from a prospective database of 16 patients who underwent LRIH between March 2014 and December 2020. The decision to do a redo laparoscopic surgery was undertaken after a detailed discussion with the patient. The operative details, challenges faced and tips to overcome difficulties have been explained in detail. Out of 16 patients (mean age 49.5 years, all men), 15 underwent laparoscopic redo trans-abdominal pre-peritoneal (TAPP) mesh repair and 1 underwent laparoscopic enhanced-view totally extra-peritoneal (eTEP) mesh repair. The mean operating time was 68.5 min for unilateral, 115 min for bilateral TAPP and 90 min for eTEP. The main contributing factors for recurrences were mesh migration, insufficient size of the mesh and inadequate fixation. There was no conversion to open repair. The duration of stay was 1-2 days. There was no documented re-recurrence during the follow-up period of 2-9 years. Based on our experience, redo laparoscopic inguinal hernia mesh repair after previous endolaparoscopic repair is feasible, effective and safe in experienced hands.

970 A Parisian Pain in the Groin; a Case of De Garengeot’s Hernia

Abstract Introduction 77-year-old gentleman presented with a four-day history of a painful right sided irreducible groin swelling. Background of previous bilateral mesh inguinal hernia repair thirty years prior. Differential diagnosis- recurrent incarcerated inguinal hernia. Description Emergency presentation with a painful right sided groin lump with history of previous inguinal hernia repair. Past medical history of AF on rivaroxaban, HTN and BPH. Patient systemically well with an irreducible lump in the right groin. CTAP showed recurrence of hernia in right inguinal region containing fat stranding and a 2cm-sized fluid-filled structure (suspected appendix). Taken to theatre the following day - oblique incision in right groin. Obvious femoral hernia identified. Haemorrhagic fluid and a necrotic appendix contained in hernia sac. Open appendicectomy performed through groin incision and femoral canal plicated using 2.0 prolene. No mesh used due to risk of contamination. Discharged day 2 post-op. Pathology confirmed acute appendicitis. Discussion Extremely rare case presentation. Femoral hernias account for 3% of all hernias and De Garengeot hernias only 1% of all femoral hernias. Furthermore, De Garengeot hernia with acute appendicitis accounts for only 0.01% of femoral hernias and are much more common in females than males with a 4:1 ratio. Femoral hernias are fifteen times more common in patients who have undergone previous inguinal hernia repair with 33% of men and 4% of women with De Garengeot hernia having undergone previous right inguinal hernia repair. Difficult pre-operative diagnosis given rarity with only 30% of cases diagnosed on pre-operative imaging-initial diagnosis Amyand hernia on CT imaging.

A ligament to identify the inferior limit of dissection in minimally invasive surgery for inguinal hernia

Background: Minimally invasive surgery has recently become the approach of choice for surgeons for inguinal hernia repair. Subsequent to excellent visualisation of the preperitoneal space by high definition and 4K systems during laparoscopy and robotic surgery, as well as increasing use of multi detector CT scans to visualise abdomen, our knowledge of the anatomy of the posterior view of inguinal region has been enhanced. However, recurrence after surgery for groin hernia continues to be an issue during its learning curve especially for laparoscopic repair. One cause for recurrence is the infolding of the mesh after its placement in the preperitoneal space. A reason for this is inadequate dissection of the peritoneal fold especially inferomedially. The peritoneum has to be dissected inferomedially till the point where the vas deferens turns medially. During the course of a randomised study done to compare Transabdominal preperitoneal mesh repair with Totally extraperitoneal mesh repair for Inguinal hernia, a structure was seen passing from the medial aspect of the vas deferens where it turned medially Methods: Prospective analysis of 106 consecutive patients who underwent laparoscopic inguinal hernia was done to identify the presence of such a ligament. Results: This study demonstrates the existence of a ligamentous structure from the vas deferens to the posterior lamina of subparietal layer of peritoneal space at the site where the vas turns medially. Conclusions: Identification and division of this ligament will help to ensure complete dissection of the peritoneum inferiorly as well as creaseless placement of mesh thus preventing recurrence.

Comparison between minimal stitch hernioplasty and continuous suturing of mesh in inguinal hernia repair: a randomised controlled trial

Background: Inguinal hernia repair is the most commonly done surgery of all general surgical procedures. Hence in an attempt to decrease the pain and increase the patient’s comfort, various techniques have been considered to fix the mesh. The aim of this study was to compare the differences between the two techniques of mesh fixation namely the minimal stitch method and the continuous suturing in terms of various parameters. Methods: This study was conducted selecting 126 patients who attended the general surgery OPD at ESIC MC and PGIMSR and randomly allocating them to the two study groups; the patients were followed up till 6 months post-operatively. The parameters taken into account were: the operative time, the duration of hospital stay, the pain scores at various time intervals (POD 1, 3, 7, 30, 60, 90, 180) and the incidence of complications if any. Results: Among the 126 male patients enrolled in the study, the highest % belonged to the age group 51-60. 90% of them had unilateral hernias. The pain scores were significantly low in the minimal stitch group from the first postoperative day up to 1 month. The operative time and duration of hospital stay was also significantly decreased in the minimal stitch group. Conclusions: Hence, the minimal stitch technique used for inguinal hernia repair in our study proved to be comparable to the conventional suturing, better than the latter in terms of patients’ subjective satisfactory factors such as less operative time and less hospital stay while having no significant difference in terms of occurrence of chronic inguinodynia or any other postoperative complications.

Outcome of Uncomplicated Inguinal Hernia Repair by Desarda Technique in Adult Male as a Day Case Surgery at Mugda Medical College Hospital

Background: Mesh repair (Lichtenstein and Laparoscopic) for inguinal hernia is the most frequently performed operation round the world. In recent years inguinal hernia surgery has undergone numerous advances. Among them, Desarda technique provides a new concept of hernia repair based on physiological principle using an undetached strip of external oblique aponeurosis. Worldwide, day case inguinal hernia surgery has been markedly increased irrespective of technique. Due to benefit of cost effectiveness and freeing of mesh related complication, Desarda technique needs to be considered as day case hernia surgery. Objectives: To evaluate outcome of day case inguinal hernia surgery in terms of immediate and early postoperative complications, rate and reasons of unanticipated admission after surgery, time of return to basic activities and recurrence rate in our setup. Methods: This observational study was carried out at the department of surgery, Mugda Medical College Hospital included 50 male patients with uncomplicated inguinal hernia during August 2019 to July 2021. Data was collected by researcher himself with using a prepared structured questionnaires & checklist and analyzed on Statistical Packages for Social Science (SPSS) 22. Results: Among 50 male patients 60% belong to low-income status, mean age was 44.09 ±10.93 years. The mean operative time was 46.31 ±12.27 mins. In the first postoperative day 22 patients reported mild pain and on third postoperative day majority (42) reported no pain. The mean duration of hospital stay was 18.16 ±11.24 hours and only 6 (12%) patients needed unanticipated admission. No severe postoperative complication, one recurrence has been reported. The mean time of return to basic activities 2.3 ±1.33 days. Conclusion: The results of the present study demonstrate that Desarda technique can be safely offered as day case hernia surgery in our country. Further study is needed for better outcome.

Return to Work in Patients With Unilateral Inguinal Hernia Surgery: A Comparative Study Between Laparoscopic Transabdominal Preperitoneal Approach and Lichtenstein Tension-Free Mesh Repair.

Objective The objective of this prospective cohort study was to compare the time to return to work between patients who underwent laparoscopic transabdominal preperitoneal (TAPP) hernia repair and those who underwent Lichtenstein tension-free hernia repair with mesh for unilateral inguinal hernia. Methodology Patients were registered for unilateral inguinal hernia review at Aga Khan University Hospital, Karachi, Pakistan, from May 2016 to April 2017 and followed till April 2020. All patients aged 16-65 planned for unilateral transabdominal preperitoneal hernia repair or Lichtenstein tension-free hernia mesh repair were included. Patients with bilateral inguinal hernia repair, limited activity, or above retirement age were excluded. A non-probability consecutive sampling technique was implemented, and patients were divided into two cohort groups: Group A underwent laparoscopic transabdominal preperitoneal hernia repair, while Group B underwent Lichtenstein tension-free mesh repair. Patients were followed up at one week to inquire about the resumption of activities and then at one and three years for recurrence. Results Sixty-four patients met the inclusion criteria; three patients opted out of research, and 61 patients agreed to participate; one patient was excluded due to the conversion of the procedure. The remaining 30 in Group A and 30 in Group B were followed for the study period. The mean time to return to work in Group A was 5.33 ± 4.46 days; in Group B, it was 6.83 ± 4.58 days, with a p-value of 0.657.One recurrence was observed at three years in Group A. Conclusion Although the time to return to work at our hospital was slightly shorter in laparoscopic hernia repair than in the open technique, the results were not statistically significant. In addition, there was no significant difference in hernia recurrence at the one-year follow-up between laparoscopic transabdominal preperitoneal hernia repair and Lichtenstein tension-free hernia mesh repair for unilateral inguinal hernia.

Frequency of Surgical Site Infection in Mesh Repair for Inguinal Hernias

OBJECTIVES To determine the frequency of surgical site infection in mesh repair for inguinal hernias. METHODOLOGY This Descriptive observational study was carried out at the Surgical B unit of Hayatabad Medical Complex Peshawar from November 2021 to October 2022. A total of 179 patients were included in the study were given a single dose of antibiotics, i.e.1, gm Ceftriaxone, one hour before inguinal hernia mesh repair.RESULTS A total of 179 patients aged between 30-60 years with a mean age of 45 years were enrolled. There were 98(54.7%) male while 81(45.3%) females. The frequency of wound infection was noted in 23 (12.8%) patients following mesh repair for inguinal hernia. Out of 23, most of the patients, 10(43.5%) had Medical redness & tenderness, 8(34.8%) patients had pus discharge from the wound side, and 5(21.7%) patients had wound site abscesses.CONCLUSION Surgical site infection after mesh repair was higher than the internationally reported incidence. Establishing a baseline SSI rate for inguinal hernia repairs offers a useful benchmark for future studies and surgical programs in these

A comparative study on short term surgical outcome between laparoscopic inguinal hernia mesh repair vs. open inguinal hernia mesh repair for primary unilateral inguinal hernias

Background: Current study was performed to compare the short-term surgical outcome of laparoscopic (TAPP) and open inguinal hernia mesh hernioplasty (Lichtenstein) in primary unilateral inguinal hernias such as time taken by patients to return to routine daily activities and return to work. Methods: This is a prospective, comparative study done in Apollo Main Hospital, Chennai comparing surgical outcomes between laparoscopic and open primary unilateral inguinal hernia mesh repair in a total of 60 patients with 30 patients in each arm. Results: Return to Job is 8 median days in laparoscopic group and 9 median days in open group which is significant with a p value of 0.000. Pain score at 12th hour is significantly lesser in laparoscopic group with a VAS score of 3 compared to open group with a VAS score of 4 with p value of 0.015. VAS score at POD 1 in laparoscopic group is 2 and in open group is 3 which is significantly lesser in laparoscopic group with a p value of 0.026. Pain score at POD 3 and 4 is significantly lesser in laparoscopic group with a p value of 0.001 and 0.008 respectively. laparoscopic group takes analgesia for a lesser number of days than the open group with a p value of 0.019. Conclusions: This study concludes laparoscopic repair for primary unilateral inguinal hernias is superior to Lichtenstein tension free mesh hernioplasty in terms of postoperative pain, early return to job and less consumption of postoperative analgesia.

The Impact of Body Mass Index on Local Anaesthetic Inguinal Hernia Repair.

Open mesh repair of inguinal hernia is acceptable and can be performed under local anaesthesia (LA). Individuals with high BMI (Body Mass Index) have often been excluded from LA repairs for varying reasons including safety concerns. Open repair of unilateral inguinal hernia (UIH) amongst individuals with different BMI groups was studied. Its safety profile was investigated using LA volume and length of operation (LO)asendpoints. Operative pain and patient satisfaction were also evaluated. A total of 438 adult patients were studied having excludedunderweight patients, those requiring any additional intra-operative analgesia, multiple procedures, or records with incomplete data.Operative pain, patient satisfaction, LO and LA volume were retrospectively studied from the existing data from clinical and operative notes. It was a predominantly male population (93.2% males) with an age range of 17-94 years peaking in the 60-69 years age group. BMI ranged 19-39 kg/m2 with BMI above normal at 62.8%. LO was 13-100 minutes (average 37 mins {SD = 12})utilising an average LA volume of 45 ml (SD = 11) per patient. Across BMI groups, no significant difference in LO (P = 0.168) or patient satisfaction (P = 0.388) was seen. AlthoughLA volume (P = 0.011) and pain score (P<0.001) demonstrated statistically significant differences, these did not appear to be clinically relevant.Over 90% in each BMI group experienced mild or no pain and with severe pain reported in only one patient in the entire population. Overall, LA volume required per patient was low and dosage was safe in all BMI groups with significant proportion (89%) of patients evaluated for satisfaction rating their experience ≥ 90 out of 100. LA repair is safe and well tolerated irrespective of BMI.BMI is not a viable reason for exclusion of obese/overweight individuals from LA repair.

A Clinical Study on the Outcomes in the Preservation and Elective Division of the Ilioinguinal Nerve in Open Mesh Repair of Inguinal Hernia

A Clinical Study on the Outcomes in the Preservation and Elective Division of the Ilioinguinal Nerve in Open Mesh Repair of Inguinal Hernia

Early sigmoid perforation involving left inguinal hernia mesh repair: a case report.

Injury to the underlying bowel is a serious potential complication following inguinal hernia mesh repair. Here the authors describe a rare case of a 69-year-old gentleman who initially presented with a deep collection in the retroperitoneum, which extended into the extraperitoneal space on the anterior abdominal wall 3 weeks following left inguinal hernioplasty. Early sigmoid perforation involving the inguinal hernia mesh repair was diagnosed, and he underwent a successful Hartmann's procedure with mesh removal.

A Rare Presentation of Vesicocutaneous Fistula as Groin Abscess after 8 Years of Laparoscopic Mesh Repair of Inguinal Hernia

Laparoscopic mesh repair of inguinal hernia is common but rarely associated with vesicocutaneous fistula as a complication. The most common implications are mesh erosion and migration due to inappropriate strategies in the selection of the mesh type, size, and placement of mesh. This case study reports a 74-year-old man who suffered immense physical, mental, and cosmetic hardship due to a vesicocutaneous fistula postlaparoscopic mesh repair of an inguinal hernia performed 8 years ago. He presented with groin abscess secondary to vesicocutaneous fistula, diagnosed with high inflammatory markers and computed tomography abdomen pelvis. Groin abscess was drained and identified vesicocutaneous fistula which was managed conservatively.

Desarda's Tissue Repair: An Efficient and Affordable Alternative to Mesh repair for Inguinal Hernia

Desarda's Tissue Repair: An Efficient and Affordable Alternative to Mesh repair for Inguinal Hernia

Fascia defect closure versus non-closure in minimal invasive direct inguinal hernia mesh repair: a systematic review and meta-analysis of real-world evidence.

Laparoscopic and robotic inguinal hernia mesh repair are both common surgical procedures worldwide. Postoperative hernia recurrence and seroma formation are important concerns. In ventral hernia, primary defect closure in laparoscopic surgery reduces the recurrence rate. However, there is no synthetic evidence of direct inguinal hernia defect closure versus non-closure in minimal invasive surgery. Therefore, this study investigated the efficacy of defect closure in patients undergoing minimal invasive direct inguinal hernia mesh repair. Eligible studies were identified through a search of PubMed, Embase, Cochrane Library, and CINAHL from their inception until March 2022. Studies examining defect closure in laparoscopic direct inguinal hernia repair were included, and a meta-analysis was performed using the random-effect model. Sensitivity analyses were performed by removing one study at a time. The primary outcomes were hernia recurrence and seroma formation. Acute and chronic postoperative pain, operation time, and length of hospital stay were the secondary outcomes. Five nonrandomized studies and one randomized controlled trial were included. Pooled analysis revealed defect closure might reduce the hernia recurrence rate (risk difference, -0.02; 95% confidence interval [CI] -0.04 to -0.00; p = 0.02). The result of seroma formation (odds ratio, 0.49; 95% CI 0.17-1.46; p = 0.20) showed no significant difference. Moreover, no significant differences were observed in acute postoperative pain, chronic pain, length of hospital stay, and operation time. Our study indicated defect closure seems to be an option to reduce the direct inguinal hernia recurrence rate. No significant benefits were shown in seroma formation and other secondary outcomes. Our study was mostly based on nonrandomized studies and underestimated the effect of defect closure; thus, further high-quality studies are required to draw definitive conclusions.

LIGHT WEIGHT VERSUS MEDIUM WEIGHT MESH IN LAPAROSCOPIC INGUINAL HERNIA MESH REPAIR

Hernia is repaired by laparoscopic or open approach. Laparoscopic inguinal hernia repairs performed are trans-abdominal preperitoneal repair (TAPP) and totally extra-peritoneal repair (TEP). This study aimed to update the previous reviews and to compare Light Weight versus Medium Weight Mesh in LIHR. Previous studies have shown benets of LWM compared to MWM in terms of decreased pain, discomfort, and early return to normal activity. Method: 50 patients operated for Laparoscopic Inguinal Hernia Mesh Repair were evaluated from Inpatient department of Sahyadri Speciality Hospital, Deccan, Pune between January 2020 to May 2021. 30 patients were operated using Anatomical 3D Light weight Mesh and 20 were operated using Paritene Flat Sheet Medium Weight Mesh; allocation done by simple randomization. It is a prospective, observational study. Aim was to evaluate the post-operative outcome and return to normal activities in LWM versus MWM in LIHR. Result: Mean duration of hospital stay, mean duration of days taken to resume daily activities, intensity of pain by VAS and NRS, foreign body sensation, incidence of seroma formation and inuence on male sexual life and fertility did not differ between patients of both groups. No signicant difference in post-operative pain and foreign body sensation between use of LWM and MWM.

Abdominal Wall Reconstruction with Retrorectus Self-Adhering Mesh: A Single-Center Long-Term Follow-Up.

Mesh repair has been demonstrated to be superior to suture alone in ventral hernia repair. In a previous short-term pilot study, the authors found lower postoperative narcotic requirements with self-adhering mesh. The aim of this study was to follow-up on that pilot study, using long-term data. This is a retrospective review of a prospectively collected database. All patients who underwent ventral hernia repair with retrorectus mesh and who had at least a 12-month follow-up were reviewed. Comparisons were performed between patients who received self-adhering mesh and those who received transfascially sutured mesh, using matched-pair analysis, examining perioperative outcomes, surgical-site occurrences, and hernia recurrence/bulge. Forty-two patients were included in the study, with 21 patients undergoing repair with transfascially sutured mesh and 21 patients receiving self-adhering mesh. Average length of follow-up was 1078 days. There were no significant differences between the two groups in baseline characteristics. Patients receiving self-adhering mesh had significantly shorter surgery, and a shorter hospital length of stay. They also had a tendency toward lower narcotic requirements. There were no significant differences in the rate of surgical-site occurrences, hernia recurrences, or bulge between the two groups. This long-term study shows that self-adhering mesh in ventral hernia repair results in similar long-term outcomes to transfascially sutured mesh, with shorter surgery, shorter length of stay, and a tendency toward improved pain control. These findings mirror the known advantages of self-adhering mesh in inguinal hernia repair. Further research is needed to study the incidence of chronic pain and the cost-effectiveness of self-adhering mesh. Therapeutic, III.

OC-045 AMBULATORY HERNIA SURGERY IN PRIMARY CARE

Abstract Background Approximately 100,000 hernia repairs are performed in the UK annually, the vast majority in hospital usually under general anaesthetic. Due to increased pressure on hospital facilities especially after the COVID-19 pandemic the waiting times for non-emergency surgery for benign conditions has increased. This study outlines the development and feasibility of a dedicated ambulatory primary care hernia service and examines the outcomes achieved between November 2018 and November 2021. Methods We prospectively analysed of records of 212 patients who underwent hernia repair in a primary care centre during the above period. Inclusion criteria were a) BMI&amp;lt;35 b) uncomplicated inguinal or umbilical hernia c) non recurrent hernia. The techniques used were Lichtenstein mesh repair for inguinal hernias and a primary sutured repair for ventral hernias. All procedures were performed as day-cases under local anaesthesia without sedation. All patients were telephoned by a healthcare professional a day after their operation. The primary outcomes of the study were length of stay, immediate complications and the secondary outcome was cost effectiveness. Results The median length of post-operative stay was 26 minutes. Complications were low and seen only in 5 patients and managed conservatively. The cost of hernia repair in primary care in UK is only £1012 when compared to £1800 in an NHS hospital. Conclusion Routine elective abdominal wall hernia repairs can be performed in a primary care setting, safely, with good clinical outcomes and clear economic benefits. However, this depends on the availability of surgeons and adequate funds to establish the service.

OC-038 RISK FOR CONTRALATERAL INGUINAL HERNIA REPAIR FOLLOWING PRIMARY UNILATERAL HERNIA REPAIR – A REGISTER-BASED STUDY

Abstract Aim To investigate the incidence as well as the factors predictive for a subsequent hernia repair on the contralateral side following a primary unilateral hernia repair. Material &amp; Methods Prospective population-based study of data from the Swedish Hernia Register based on 151,297 patients operated with an index unilateral inguinal hernia mesh repair using open and endo-laparoscopic technique, during 2007–2019. Incidence, predictive factors and time to a contralateral hernia repair was analysed. Results There were 7.4% registered contralateral hernia repairs with a median time of 2.7 years to a subsequent contralateral repair following the index unilateral hernia repair. Median follow-up time was 7.5 years. Significant predictors for a subsequent contralateral hernia were, male sex (HR 1.78, 95% CI 1.61–1.97), high age (HR 1.01 95% CI 1.006–1.009), medial inguinal hernia (HR 1.05, 95% CI 1.003–1.098), combined inguinal hernia (HR 1.10, 95% CI 1.03–1.18), hernia defect size 1.5–3.0 cm (HR 1.10, 95% CI 1.03–1.17), hernia defect size &amp;gt; 3 cm (HR 1.36, 95% CI 1.27–1.45) and a repair on the left side (HR 1.30, 95% CI 1.25–1.35). Endo-laparoscopic repairs and obesity were associated with a lower incidence of a later contralateral repair. Conclusion If the relevant risk factors, i.e., male sex, high age, large hernia defect size, medial or combined hernia, are present at a unilateral endo-laparoscopic groin hernia repair and the decision has been shared with the patient, exploration of the contralateral groin and prophylactic mesh placement may be considered.

“Comparative Study to Evaluate Post Operative Pain in Management of Open Inguinal Hernia Repair With and Without Inguinal Nerve Block”

Background: Inguinal hernia repair is most frequently preformed surgeries by most of the general surgeons worldwide. Pain is the most common symptom post operative in both immediate and chronic phase. Pain management in these patients, especially in the immediate post operative time, is major concern for both patients and the medical fraternity.Material &amp; Methods: A comparative study to evaluate the post operative pain in management of open inguinal hernia repair with and without inguinal nerve block was conducted at Dept. of General Surgery in Santosh Medical College and Hospital, Ghaziabad on patients admitted in Dept of General Surgery from September 2020 to August 2021. All patients underwent Lichtenstein tension free mesh repair for inguinal hernia. Half the patients randomly selected were given inguinal nerve block using 0.25% levobupivicaine.Results: Nerve blocks have been used for chronic pain managements in past in post op inguinal hernia repair surgeries. Present study deals with pain management in immediate post- operative pain management. It shows significant difference is noted in patients receiving the nerve block not only in pain but also comfort levels, post operative mobility, day of discharge and retention of urine.Conclusion: Use of nerve blocks in patients undergoing open inguinal hernia repair is beneficial for the patient with improved outcome.