A Clinical Study of Lichtenstein Tension-Free Prolene Mesh Hernioplasty in Cases of Inguinal Hernia

Background: Main reason for intervention in inginal hernia was continuous growth of inguinal and scrotal swelling, the risk of incarceration and bad results of conservative methods like truss placement. Surgical techniques have evolved rapidly since Edoardo Bassini proposed his first successful reconstruction of the inguinal floor. Various adaptations of his technique did however not result in substantial reduction in number of recurrences. The danger of high recurrence rate that had loomed low over the heads of hernia surgeons in the past had been dissipated by the advent of Lichtenstein tension-free prolene mesh inguinal hernia repair. Methods: 50 patients were subjected to prolene mesh of which 5 patients underwent bilateral repair of inguinal hernia. The follow up and pre-operative investigations were done on O.P.D basis. All elective patients were admitted a day prior to surgery. The patients were kept nil by mouth overnight. Spinal anaesthesia was used in all cases. Post-operative antibiotics were given and analgesics were given on demand basis. All except one patient were discharged on 3rd post-operative day. Results: Inguinal hernias were found to be more common in males (98%) than females. 28% patients were found in the age group 61-70 years. 60 % operated hernias were indirect type,36.38% operated hernias were of direct type, while 1.81% pantaloons and 1.81% recurrent inguinal hernias were subjected to prolene mesh repair. 81.82% hernias were incomplete while 18.18% hernias were complete. 98.19% hernias on clinical presentation were reducible and 1.81% presented as obstructed inguinal hernia. Hypertension (12%) was the most common co-morbid condition encountered in our study. Only one patient in our study (1.81%) developed localized subcutaneous infection, only one patient (1.81%) developed testicular pain which was due to scrotal oedema. One (1.81%) patient in our series complained pain in operative region which lasted not more than 2 months and was subsided by analgesics. 98% patients were discharged on 3rd post-oprerative day. Conclusion: Lichtenstein repair has become gold standard in hernia surgery. The repair is physiologically sound as it buttresses the posterior wall of inguinal canal, weakness of which is the reason behind development of inguinal hernia. The repair has a very short learning curve with high degree of reproducibility. Prolene mesh repair does not result in higher rate of infection. Tension-free nature of the repair which we used, results in reduced pain in post-operative period. We could not find a single case of recurrence. Considering the wide range of advantages this repair secures for the patient, the cost of prolene mesh seems nominal only.