Mesh Repair Of Inguinal Hernia Research Articles

Single-port onlay mesh repair of recurrent inguinal hernias after failed anterior and laparoscopic repairs.

Background and Objectives:Despite the exponential increase in the use of laparoscopic inguinal herniorrhaphy, overall recurrence rates have remained unchanged. Therefore, a growing number of patients are presenting with recurrent hernias after conventional anterior and laparoscopic repairs have failed. This study reports our experience with single-incision laparoscopic (SIL) intraperitoneal onlay mesh (IPOM) repair of these hernias.Methods:Patients referred with two or more recurrences of inguinal hernia underwent SIL-IPOM from November 1, 2009, to June 24, 2014. A 2.5-cm infraumbilical incision was made, and an SIL port was placed intraperitoneally. Modified dissection techniques were used: chopstick and inline dissection, 5.5-mm/52-cm/30° angled laparoscope, and conventional straight dissecting instruments. The peritoneum was incised above the pubic symphysis, and dissection was continued laterally and proximally, raising the inferior flap below the previous extraperitoneal mesh while reducing any direct, indirect, femoral, or cord lipoma before placement of antiadhesive mesh, which was fixed to the pubic ramus, as well as superiorly, with nonabsorbable tacks before the inferior border was fixed with fibrin sealant. The inferior peritoneal flap was then tacked back onto the mesh.Results:Nine male patients underwent SIL-IPOM. Their mean age was 53 years and mean body mass index was 26.8 kg/m2. Mean mesh size was 275 cm2. Mean operation time was 125 minutes, with a hospital stay of 1 day. The umbilical scar length was 23 mm at the 6-week follow-up. There were no intra-/postoperative complications, port-site hernias, chronic groin pain, or recurrence of the hernia during a mean follow-up of 24 months.Conclusion:Inguinal hernias recurring after two or more failed conventional anterior and laparoscopic repairs can be safely and efficiently treated with SIL-IPOM.

RESEARCH OF USING ULTRASOUND IN DIAGNOSIS AND LICHTENSTEIN FOR INGUINAL HERNIAS REPAIR

Background: Inguinal hernia is a common disease in general surgery. Treatment with Lichtenstein procedure is applicate in the worldwide. Study objectives: The ultrasound may be evaluate the using of polypropylene mesh by Lichtenstein for inguinal hernias.Materials and Method: Prospective study in 176 patients with 193 inguinal hernias. Hernioplasty by Lichtenstein procedure from September 2009 to December 2012 in Hue Central Hospital. Results: The right hernia 49.4%, left hernia 40,9%, bilateral hernia 9.7%, fibromesh 100%, thick fibromesh 2.53 ± 0.23 mm, seroma 3,6%. Conclusions: Sonography can be effective for evaluation of fibromesh and complication after mesh repair of inguinal hernias. Key words: Inguinal hernia; Lichtenstein, ultrasound

Incidence of complications following open mesh repair for inguinal hernia

Background: Traditional suture repair of inguinal hernia is fast giving way to routine tension-free mesh repair. In many countries, mesh repair is now more common than suture repair. Objective: To study mesh related complications in the early postoperative period in patient with inguinal hernia. Methods: This cross-sectional study was conducted at Khartoum teaching hospital. One hundred and three patients who had mesh repair for inguinal hernia were the base for this study between January and December 2011 using a structured questionnaire. Results: The mean age of the patients is 43.203 14.41 years (STD). There were 95.1% males (n=98) and 4.9% females (n=5). Tension-free mesh repair was done for 103 patients, 12 patients (11.3%) developed wound hematoma, another 12 patients (11.3%) developed numbness at the site of operations, 11 patients (10.7%) developed scrotal swelling, nine patients (8.7%) developed seroma and four patients (3.9%) developed neuralgia at the site of operations. Conclusion: Mesh repair of inguinal hernias is not free of complications. A larger sample size and further studies are needed to compare outcome of mesh repair in our environment more objectively with traditional inguinal hernia repair. Keywords: Inguinal Hernia; Mesh Repair; Complications.

An international consensus algorithm for management of chronic postoperative inguinal pain.

Tension-free mesh repair of inguinal hernia has led to uniformly low recurrence rates. Morbidity associated with this operation is mainly related to chronic pain. No consensus guidelines exist for the management of this condition. The goal of this study is to design an expert-based algorithm for diagnostic and therapeutic management of chronic inguinal postoperative pain (CPIP). A group of surgeons considered experts on inguinal hernia surgery was solicited to develop the algorithm. Consensus regarding each step of an algorithm proposed by the authors was sought by means of the Delphi method leading to a revised expert-based algorithm. With the input of 28 international experts, an algorithm for a stepwise approach for management of CPIP was created. 26 participants accepted the final algorithm as a consensus model. One participant could not agree with the final concept. One expert did not respond during the final phase. There is a need for guidelines with regard to management of CPIP. This algorithm can serve as a guide with regard to the diagnosis, management, and treatment of these patients and improve clinical outcomes. If an expectative phase of a few months has passed without any amelioration of CPIP, a multidisciplinary approach is indicated and a pain management team should be consulted. Pharmacologic, behavioral, and interventional modalities including nerve blocks are essential. If conservative measures fail and surgery is considered, triple neurectomy, correction for recurrence with or without neurectomy, and meshoma removal if indicated should be performed. Surgeons less experienced with remedial operations for CPIP should not hesitate to refer their patients to dedicated hernia surgeons.

Is it really worth it? Reply to: Selective use of bioabsorbable Gore BIO-A plug and patch for groin hernia repair. Negro P, Campanelli G, Ipponi PL, Gossetti F, Dassatti MR, Manto O, D'Amore L. Hernia. 2013, 17(6):795-6.

It is a great pleasure for us to realize that what started as a heretic idea in our department found supporters or, better, in order to be more precise, colleagues sharing the same research ideas and dilemmas within the hernia repair surgical society. So, ‘‘we are not alone’’. Indeed, we continue to believe that chronic pain and, generally, the interactions of the different mesh type’s materials with the host tissues are still the most ill-investigated field in inguinal hernia repair with great perspectives for future development and progress. We would like to start this response by stating right from the outset that our response probably entails bias as in many instances there are no unequivocal evidences to be supported from. We read with great interest the report by Negro et al. [1] dealing with their experience out of the use of the Bio A totally absorbable material as the sole mesh for inguinal hernia repair. The authors have used the Shumbelick classification of inguinal hernias in order to sub-classify patients with lateral inguinal hernias according to the magnitude of the defect [1]. In addition, they have adopted a modified repair technique altering the normal anatomy by placing the external oblique aponeurosis dorsally to the spermatic cord [1]. Although the authors report a significantly better recurrence rate than the one reported in our recent report [2], we would rather avoid entering into a discussion relevant to the actual causes of this finding. We do believe that Negro et al. [1] have supplied adequate arguments on the subject and we tend to agree with the majority of them. However, to our opinion, it is still a result that requires proper interpretation. Negro et al. [1] have concluded that this certain mesh type can indeed have an indication for inguinal hernia repair. Young (\45 years) patients with small inguinal hernias (L1 and L2) without a notable defect in the transversalis fascia verified with the intra-operative stress test could be the ideal candidates for having their hernia repaired with the use of this totally absorbable mesh [1]. The reproducibly of this test though, could be quite problematic, as by definition, general anesthetic, currently the mainstream anesthesia for inguinal hernia repair in the majority of Northern European countries [3], is precluded as a valid alternative for the procedure from the anesthetic viewpoint. Furthermore, we would consider the above modification of the textbook tension-free technique as an alternative repair on its own, although not properly validated, especially if a small lateral inguinal hernia is the case. Although this maneuver can indeed aid in lowering the recurrence rate, can prove especially misleading if the evaluation of the efficacy of the mesh used is the actual challenge. In L1 and L2 patients, i.e., the patients group ‘‘suitable’’ for this type of mesh according to Negro et al., the benefits in terms of recurrence rate reduction of the use of a prosthetic mesh are not as obvious as in patients with large defects [4]. Negro et al. have witnessed a total failure of the followed repair in all (2 patients) L3 hernia patient, the patient group definitely in need of a repair reinforcement, i.e., a mesh. Within this context, the almost axiomatic adage that a large hernia needs a mesh in order to lower to an acceptable range the recurrence rate, does not seem to be fulfilled by This reply refers to the article available at doi:10.1007/s10029-013-1117-4.

Antisperm antibodies and testicular blood flow after inguinal hernia mesh repair.

Testicular flow studies after hernia mesh repair mostly showed different outcomes. The reason of infertility in some men after hernia repair is immunological factors. Aim of the study was to investigate the influence of mesh hernia repair on antisperm antibodies production and testicular blood flow and a connection among these parameters. A prospective interventional longitudinal cohort study was made on 82 male patients without exclusion criteria who had an inguinal hernia. Patients underwent laparoscopic TAPP or open tension-free hernia repair. Vascular ultrasound and antisperm antibodies were measured in the preoperative and postoperative periods. Main outcome measures were resistive index (RI), peak systolic velocity (PSV) cm/s, and end-diastolic velocity (EDV) cm/s in testicular blood flow measurement and the quantitative value of antisperm antibodies (ASA) in serum (IU/ml). ASA significantly increased postoperatively only in patients who underwent open tension-free hernia repair (p < 0.001). ASA stayed in normal range in all patients except the one with postoperative complication. Friedman analysis showed significant change of the RI only on intratesticular (p < 0.001) and capsular artery level (0.02) in patients who underwent laparoscopic technique. PSV significantly changed on intratesticular (p < 0.001) and capsular artery level (p = 0.015) in the laparoscopic hernia repair. PSV showed significant change on intratesticular (p < 0.001) and testicular artery levels (p < 0.001) in the open tension-free hernia repair. EDV showed significant change only on testicular artery level (p = 0.032) in the patients who had open tension-free hernia repair. These blood flow parameters significantly increased in the early postoperative period and returned on basal value in the late postoperative period. Parameters of flow did not show any significant correlation with ASA. Mesh hernia repairs without complication caused only a transitory change in testicular blood flow and no clinical significant autoimmune reaction.

Assessing the impact of short-term surgical education on practice: a retrospective study of the introduction of mesh for inguinal hernia repair in sub-Saharan Africa.

Inguinal hernia repair is the most common general surgery operation performed globally. However, the adoption of tension-free hernia repair with mesh has been limited in low-income settings, largely due to a lack of technical training and resources. The present study evaluates the impact of a 2-day training course instructing use of polypropylene mesh for inguinal hernia repair on the practice patterns of sub-Saharan African physicians. A surgical training course on tension-free mesh repair of hernias was provided to 16 physicians working in rural Ghanaian and Liberian hospitals. Three physicians were requested to prospectively record all their inguinal hernia surgeries, performed with or without mesh, during the 14-month period following the training. Demographic variables, diagnoses, and complications were collected by an independent data collector for mesh and non-mesh procedures. Surgery with mesh increased significantly following intervention, from near negligible levels prior to the training to 8.1 % of all inguinal hernia repairs afterwards. Mesh repair accounted for 90.8 % of recurrent hernia repairs and 2.9 % of primary hernia repairs after training. Overall complication rates between mesh and non-mesh procedures were not significantly different (p = 0.20). Three physicians who participated in an intensive education course were routinely using mesh for inguinal hernia repair 14 months after the training. This represents a significant change in practice pattern. Complication rates between patients who underwent inguinal hernia repairs with and without mesh were comparable. The present study provides evidence that short-term surgical training initiatives can have a substantial impact on local healthcare practice in resource-limited settings.

Feasibility and outcomes regarding open and laparoscopic radical prostatectomy in patients with previous synthetic mesh inguinal hernia repair: meta-analysis and systematic review of 7,497 patients.

The purpose of this article is to contribute information to the interpretation of the feasibility and outcomes regarding open, laparoscopic and robotic strategies of radical prostatectomy in patients with previous synthetic mesh inguinal hernia repair. A bibliographic search covering the period from January 1980 to September 2012 was conducted in PubMed, MEDLINE and EMBASE. Database searches yielded 28 references. This analysis is based on the eleven studies that fulfilled the predefined criteria. A total of 7,497 patients were included. In the study group, there were 462 patients. The surgical prostatectomy techniques were open in five studies, laparoscopic in three and robotic in the remaining three. The control group consisted in 7,035 patients. The comparison of the open procedure performed in patients with a previous mesh herniorrhaphy and controls shows that the number of lymph nodes removed resulted significantly lower and hospital stay with catheterization time results statistically longer. The comparison of the laparoscopic procedure does not evidence a statistically significant difference in terms of blood loss, operative time and catheterization time, while the comparison with the robotic group could not be performed for the lack of data. All patients need an adequate informed consent regarding the multitude of aspects which may be influenced by the mesh such as the possibility of hernia recurrence, mesh infection, need for mesh explantation, possibility of mesh erosion into the bowel or bladder, bladder neck contractures or postoperative urinary incontinence and a compromised nodal staging.

Comparative study between Laparoscopic Trasabdominal Preperitoneal (TAPP) inguinal hernia repair and open mesh repair in Medical city.

Background: Inguinal hernias are a common medical problem that can significantly decrease the quality of life.Repair of inguinal hernia is one of the commonest surgical procedures worldwide irrespective of the country, race, or socioeconomic state. The inguinal hernia repair has been a controversial area in surgical practice from the time it has been conceived. Laparoscopic inguinal hernia repair has shown a great deal of promise as a treatment for the condition.Objectives: To compare the outcome of laparoscopic versus open inguinal hernia mesh repair in terms of operative time , analgesics requirement , postoperative complication , hospital stay and return to daily activities and work.Patients and methods: A prospective study of 80 patients with inguinal hernia repair, carried out during the period from January 2010 till January 2013, Baghdad Teaching Hospital\Medical City, Iraq, to compare the effectiveness and safety of laparoscopic and conventional open mesh techniques. Those patients were divided into 2 groups (each group of 40 patients); 1st group treated by laparoscopic (TAPP) repair and the 2nd one by open technique (mesh repair).Results: The mean operating time in laparoscopic repair was 55 minutes (45-120) while in open repair it was 38 minutes (30-110) .The laparoscopic repair was superior to open repair in regard to ; less analgesic requirement post operatively , short hospital stay , and faster return to daily activities and workThere was no statistically significant difference between the two groups regarding complications.Conclusion: Laparoscopic hernia repair is equally safe and can provide less postoperative morbidity in experienced hands Therefore laparoscopic hernia repair can be safely recommended for most cases of inguinal hernia unless laparoscopy itself is contraindicated.

Trans‐Rectus Sheath Extra‐Peritoneal Procedure (TREPP) for Inguinal Hernia: The First 1,000 Patients

Introduction After the introduction of mesh in inguinal hernia repair, the focus to improve surgical technique has changed from recurrence to chronic postoperative inguinal pain. At present, the most common surgical techniques are the Lichtenstein hernioplasty and total extraperitoneal procedure. Both techniques have their own specific disadvantages, with regard to potential nerve damage and the necessity of general anesthesia, respectively.

Prospective Randomized Trial of Long-Term Results of Inguinal Hernia Repair Using Autoadhesive Mesh Compared to Classic Lichtenstein Technique With Sutures and Polypropylene Mesh

IntroductionThe use of autoadhesive meshes with hooks that allow fixation without sutures is a therapeutic alternative to decrease recurrence and chronic pain after inguinal hernia repair. The aim of this study was to evaluate if this kind of mesh has any advantage in long term results in comparison with the classic Lichtenstein technique with sutures and polypropylene mesh. Materials and methodsWe report a prospective and randomized study of patients who have been operated on for inguinal hernia between March of 2009 to March 2010, divided into 2 groups of 45 patients. In autoadhesive (AA) group, we included patients operated on with an autoadhesive mesh and in classic Lichtenstein (CL) group we included cases with an inguinal hernioplasty with sutured polypropylene mesh. We evaluated time of inactivity, complications, recurrences and grade of pain after 1 year. ResultsThe mean age was 60 years in AA group and 49 in LC group. There were more men than women and there were no differences in co-morbidities between groups. The mean size of hernia orifice was 3cm in both groups and 60% of the hernias were indirect.After 1 year, 77 patients were evaluated, 39 in LC group and 38 in AA group. 86.8% and 87.2% of them were asymptomatic. The mean time of recovery of daily activities was 15 days in both groups. There were neither recurrences nor severe chronic pain in the AA group. The mean of grade of pain was 0 (range: 0–4) in AA group and 0 (range: 0–5) in LC group. In this group, there was one recurrence and one patient was taking analgesics for intense pain. Neither mortality nor other long term complications were found. ConclusionThe use of autoadhesive and parcial reabsorbible meshes in inguinal hernia repair has no effect on recovery of daily activities, postoperative pain and long term complications compared with hernioplasty with polypropylene mesh fixed with monofilament suture.

Short- and long-term outcomes of open inguinal hernia repair: comparison of the Prolene Hernia System and the Mesh Plug method

Tension-free mesh repair of adult inguinal hernias has become a standard procedure, but there have been few comparisons of the postoperative outcome after hernia repair using the Prolene Hernia System (PHS) vs. the Mesh Plug (MP) method in a large number of patients from a single institution. We reviewed the medical records of patients to investigate the short- and long-term outcomes of the different types of hernia repair. Late symptoms were evaluated by questionnaire. A total of 1,141 repairs performed from 1999 to 2008 (PHS in 957 and MP in 184 repairs) were evaluated. There were 93 early postoperative complications (8.2%). A subcutaneous hematoma was found more frequently after MP repair compared with after PHS repair (3.8 vs. 1.3%, P = 0.013). Seven hundred and ten patients (62.2%) could be followed up for more than 2 years. Recurrence was detected in 14 patients with PHS repair and two patients with MP repair (1.5 vs. 1.1%, P = 0.956). Wound infections occurred in three patients (0.3%) with PHS repair vs. none with MP repair (P > 0.999). Patients with PHS and MP repair showed no significant differences in the long-term wound pain. The recurrence and wound infection rates were similar after hernia repair using the PHS and MP methods. Patients undergoing PHS repair developed fewer subcutaneous hematomas. An older age (≥65 years) was a significant independent risk factor for recurrence.

Trans Rectus Sheath Extra-Peritoneal Procedure (TREPP) for Inguinal Hernia: The First 1,000 Patients

After the introduction of mesh in inguinal hernia repair, the focus to improve surgical technique has changed from recurrence to chronic postoperative inguinal pain. At present, the most common surgical techniques are the Lichtenstein hernioplasty and total extraperitoneal procedure. Both techniques have their own specific disadvantages, with regard to potential nerve damage and the necessity of general anesthesia, respectively. The goal of this study was to evaluate the results of a new technique in which the inguinal nerves are not at risk, and in which general anesthesia is not needed: trans rectus sheath extraperitoneal procedure (TREPP). Between 2006 and 2010, a total of 1,000 patients were treated for inguinal hernia with TREPP. A questionnaire concerning pain, sensibility changes, patient satisfaction, and recurrence was sent to all patients. The questionnaire was completed by 932 patients. Almost 90% of patients had not experienced any pain since the surgical procedure; 8% of patients reported experiencing some pain, but less than preoperatively; and 2% of patients reported an increase in pain postoperatively. Recurrence occurred in 1 and 3% were unsure about this. Reduced sensibility of the scar, scrotum, and upper leg was reported by 12.4, 1.4, and 1.5%, respectively. Overall, 97.4% of patients were satisfied with the results of the surgical procedure. The time period in which TREPP was performed was not associated with any of the outcome measures. TREPP has proven to be a feasible new technique for inguinal hernia repair, with excellent results, justifying a randomized controlled trial in which TREPP should be compared with standard techniques.

Preperitoneal sutureless mesh repair of inguinal hernia by open inguinal approach using inferior epigastric vessel complex as landmark: A tertiary care centre experience

Introduction: The study is a clinical trial done on patients with inguinal hernia, who were treated by open preperitoneal sutureless mesh repair, using inferior epigastric vessel complex as landmark. Aim: To study the postoperative complications and recurrence rates associated with the open preperitoneal sutureless mesh repair. Materials and Methods: Total 100 patients of inguinal hernia were recruited in this clinical trial from January 2009 to December 2012. Those with bilateral inguinal hernia or recurrent hernias were excluded from the study. Results: The average time taken to complete the surgery was 42.2 minutes and the average hospital stay was 2.5 days. Post-surgery, at a median follow-up period of 2 years, only 2 patients had seroma formation. Visual analog scale pain scores of 4 and 6 were seen in 60% and 40% cases, respectively. No recurrences were encountered post-surgery in any of the case till the last follow-up. Conclusion: This procedure was found to have fewer complications and was less time-consuming as compared to the other conventional open hernia repairs.

Partial preperitoneal mesh repair of inguinal hernia :A new approach

Context One of the commonly performed surgeries for inguinal hernias is tension free mesh repair Lichtenstein Mesh Repair. Recurrence after lichtenstein repair varies between 0-12 with a mean of 3-4. The common sites of recurrences include area just above and lateral to pubic tubercle area lateral to internal ring. The following study is conducted with the intension of evaluating the efficacy of the newer method of mesh fixationAim To study the factors of postoperative pain morbidity and recurrence following partial pre-peritoneal mesh repair of inguinal hernia and comparing the same with Lichtenstein repair of inguinal herniaMethods and Material Patients were divided into group A and group B who underwent Lichrenstein and partial pre-peritoneal mesh repair respectively. Postoperatively patients were followed up up to 1 year and various factors such as pain loss of sensation and recurrence were evaluated.Results During 8 day follow-up patients who underwent partial pre-peritoneal mesh repair complained less pain compared to other group. But they had higher chance of loss of sensation. During later follow-ups no significant difference was noted. No recurrence was noted in our study.Conclusion Partial pre-peritoneal mesh repair can be used as an effective alternative to Lichtenstein mesh repair with the advantage of covering the potential weak point of medial and lateral ends inguinal canal more widely.nbsp

Value innovation: an important aspect of global surgical care

IntroductionLimited resources in low- and middle-income countries (LMICs) drive tremendous innovation in medicine, as well as in other fields. It is not often recognized that several important surgical tools and methods, widely used in high-income countries, have their origins in LMICs. Surgical care around the world stands much to gain from these innovations. In this paper, we provide a short review of some of these succesful innovations and their origins that have had an important impact in healthcare delivery worldwide.ReviewExamples of LMIC innovations that have been adapted in high-income countries include the Bogotá bag for temporary abdominal wound closure, the orthopaedic external fixator for complex fractures, a hydrocephalus fluid valve for normal pressure hydrocephalus, and intra-ocular lens and manual small incision cataract surgery. LMIC innovations that have had tremendous potential global impact include mosquito net mesh for inguinal hernia repair, and a flutter valve for intercostal drainage of pneumothorax.ConclusionSurgical innovations from LMICs have been shown to have comparable outcomes at a fraction of the cost of tools used in high-income countries. These innovations have the potential to revolutionize global surgical care. Advocates should actively seek out these innovations, campaign for the financial gains from these innovations to benefit their originators and their countries, and find ways to develop and distribute them locally as well as globally.

Comparison of inguinal hernia repair under local anesthesia versus spinal anesthesia.

Background. Inguinal hernia is one of the most common diseases in the males. Treatment of this pathology is exclusively surgical . While in the past hernia surgery was carried out mainly under general and spinal anesthesia, in recent years there has been growing emphasis on the role of local anesthesia. Local anesthesia for inguinal hernia repair is cost-effective, but fear of intra-operative pain may hinder its widespread use. Objectives.To evaluate the safety and effectiveness of inguinal hernia repair under local anaesthesia. To compare the inguinal hernia repair under local anaesthesia versus spinal anaesthesia in relation with post operative pain, complications and hospital stay. Material and Methods; This prospective study comprised of 50 cases of inguinal hernia which were randomly divided into two groups of 25 each named group A and group B. Inguinal hernia mesh repair was done under local anaesthesia in group A and under spinal anaesthesia in group B. All the parameters were recorded intra and postoperatively in both groups. Data was compiled and subjected to statistical analysis by using paired student t test. conclusion: Tension-free mesh repair under local anaesthesia is simple, safe, cost effective, very low rates of complications and a speedy discharge.

A Comparative Study of Cost effectiveness of Net Mesh Vs Proline Mesh Inguinal Hernia Repair - An Experience at Rural Area of U.P.

A Comparative Study of Cost effectiveness of Net Mesh Vs Proline Mesh Inguinal Hernia Repair - An Experience at Rural Area of U.P.

A Comparative Study between Modified Bassini's Repair and Lichtenstein Mesh Repair (LMR) of Inguinal Hernias in Rural Population.

Bassini's repair and the Lichtenstein's tension free mesh hernioplasty are commonly used hernia repair techniques and yet there is no unison as to which is the best technique. Our hospital being in a rural setup and catering to majority of poor patients who are daily wagers, open hernia repairs are commonly done. This study was undertaken to compare the technique and post-operative course so as to determine the best suitable of the two procedures for them. A comparative randomized study was conducted on a total of 70 patients with inguinal hernia and were operated upon by either of technique and followed up. Outcome of both the techniques were analyzed and compared with other similar studies. Study involved 35 each of Modified Bassini's Repair (MBR) and Lichtenstein's Mesh Repair (LMR), over a period of 18 months. MBR took more operating time than LMR. Commonest complication in both the groups was seroma formation. There were two recurrences in the MBR group and none in LMR group. LMR was comparatively better than MBR due to its simplicity, less dissection and early ambulation in the post-operative period and with no recurrence, in our study.

Intra-abdominal giant infected seroma following laparoscopic inguinal hernia repair

Seroma formation following open or laparoscopic mesh repair of inguinal hernia is common, albeit with no impact on recovery. One of the possible complication from such a seroma is infection. A patient presented with such an infective complication 6 years following a total extra peritoneal (TEP) repair of bilateral inguinal hernia. This report gives an account of its management.