Randomised study of Lichtenstein compared with Shouldice inguinal hernia repair by surgeons in training

Danielsson, Peter; Isacson, S; Hansen, Michael V.

doi:10.1080/110241599750007504

Cited by 82 publications

(44 citation statements)

References 7 publications

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“…The duration of operation was similar for both techniques, which is in accordance with other randomized studies 14,15 . The incidence of peritoneal tears and intra-abdominal gas leakage is reported to be 40-47 per cent 16,17 .…”

Section: Discussionsupporting

confidence: 90%

Short-term results of a randomized clinical trial comparing Lichtenstein open repair with totally extraperitoneal laparoscopic inguinal hernia repair

Eklund¹,

Rudberg²,

Smedberg

et al. 2006

British Journal of Surgery

131

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Background: Laparoscopic herniorrhaphy has emerged as a recognized operative method for inguinal hernia repair. This study compared the short-term results of two tension-free methods of repair: totally extraperitoneal (TEP) laparoscopic patch repair and the open Lichtenstein mesh technique.Methods: A total of 1513 men from 11 hospitals who presented with a primary unilateral inguinal hernia were randomized to one of the two methods. Operating time, short-term complications, reoperations, postoperative pain, consumption of analgesics, sick leave and time to resumption of normal physical activities were recorded. Results: Some 1371 of the 1513 men underwent surgery, 665 in the TEP group and 706 in the Lichtenstein group. The median duration of operation was 55 min for both procedures and 91·0 per cent of the patients in both groups were discharged on the day of operation. Patients in the TEP group experienced less postoperative pain (P < 0·001), consumed fewer analgesics (P < 0·001), had a shorter period of sick leave (7 versus 12 days; P < 0·001) and a shorter time to resumption of normal physical activity (20 versus 31 days; P < 0·001). Conclusion:The TEP technique took no longer to perform, and was associated with less postoperative pain, a shorter period of sick leave and a faster recovery, compared with open Lichtenstein hernia repair.

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Section: Discussionsupporting

confidence: 90%

Short-term results of a randomized clinical trial comparing Lichtenstein open repair with totally extraperitoneal laparoscopic inguinal hernia repair

Eklund¹,

Rudberg²,

Smedberg

et al. 2006

British Journal of Surgery

131

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“…Yet the results from a study conducted by Danielson et al amongst a list of open repairs Lichtenstein's requires lesser expertise with a less steep learning curve. 26 The Desarda technique for inguinal hernia repair is a new tissue-based method. Despite the objections presented by some authors, application of the external oblique muscle aponeurosis in the form of an undetected strip (which makes the posterior wall of the inguinal canal stronger) has been established as a new concept in tissue based hernia repair.…”

Section: Discussionmentioning

confidence: 99%

Desarda’s versus Lichtenstein technique of inguinal hernia repair

Obaid¹

2017

Int Surg J

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INTRODUCTIONInguinal hernia is one of the most common diseases manage by surgeon.1 A hernia is abnormal protrusion of a viscus or a part of viscus through an opening in the wall of cavity containing it. It tends to occur at natural areas of weakness, where muscles are not strong and are vulnerable to intra-abdominal pressure. The estimated lifetime risk for inguinal hernia is 27% for men and 3% for women. 2The choice of a surgery depends on the surgeon as there were no written surgical guidelines for hernia treatment till 2009. [3][4][5] There is a considerable variation in the efficiency of all these procedures which is calculated by the rate of recurrence, complications which is also influenced not only by the different techniques but also by experience and the technical skills of the surgeons. 6 However, the ideal method for modern hernia surgery should be simple, cost effective, safe, tension free and permanent. The Lichtenstein operation to a great extent ABSTRACT Background: Ideal method for modern hernia surgery should be simple, cost effective, safe, tension free and permanent. The Lichtenstein operation to a great extent achieves this entire goal. The Lichtenstein mesh repair is associated with complications, postoperative dysfunction and high cost composite meshes. Desarda's technique, became a new surgical option for tissue-based inguinal hernia repair. The present study was designed to evaluate and compare the effectiveness and complications of the Desarda's repair with Lichtenstein tension-free mesh repair for treatment of inguinal hernia in a developing country. Methods: 200 patients with unilateral, primary, reducible inguinal hernia were selected. Included patients were randomly divided into two groups. Studied parameters were Duration of surgery, intra operative complications, postoperative Pain, Duration of hospital stay, return to normal activities, post-operative complications and recurrences. Results: There were a total of 100 patients each group. There was no statistically significant difference in duration of surgery and complication rate between the two groups. Difference in mean VAS was not statistically significant. The mean hospital stay in Desarda's technique was 2.5 days while it was 2.6 days in Lichtenstein's group. The mean time to return to basic physical activity in the Desarda's technique was 12.6 days while it was 13.3 days in the Lichtenstein's group. There were no recurrences in either group. Chronic inguinal pain (>1month) was more frequent in Lichtenstein's group. Conclusions: There is no significant difference in duration of surgery, intra operative complication rate, postoperative pain, complications and recurrence, between Desarda's technique and Lichtenstein's technique. However chronic inguinal pain is less in Desarda's technique. Desarda's repair must be considered in young patients (<30 years). Its long-term efficacy needs to be studied with larger, prospective double-blind randomized trials, with longer follow-up.

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“…According to the Swedish Hernia Register, 80% of all inguinal hernia operations in year 2000 were mesh repairs [5]. Studies suggest that mesh operations are superior to open suture repairs both in terms of lower recurrence rate and a shorter convalescence [6][7][8]. The most widely used prosthetic material in hernia surgery is polypropylene.…”

Section: Introductionmentioning

confidence: 99%

Does Mesh Implantation Affect the Spermatic Cord Structures after Inguinal Hernia Surgery?

Berndsen

Bjursten

Simanaitis³

et al. 2004

Eur Surg Res

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Background: Inguinal hernia repair is the most common operation in general surgery. Prosthetic reinforcement of the inguinal area with polypropylene mesh has increased dramatically in the last decade. The aim of this study was to evaluate how different types of mesh affect the spermatic cord structures. Methods: Thirty rats were divided into three groups. The spermatic cord was dissected free and a conventional suture repair was performed in group I, an operation mimicking the Lichtenstein operation with a heavyweight polypropylene mesh in group II and the same operation using large pore, lightweighted polypropylene/polyglactin composite mesh in group III. A vasography was performed after 90 days. The cross-sectional area of the vas deferens and s-testosterone from the spermatic vein were measured using the contralateral side as control. Light microscopy of the inguinal canal was performed and inflammation and fibrosis were graded. Results: Vasography revealed patent vas deferens in all animals. In group III, there was a lower s-testosterone in the spermatic vein and a reduced cross-sectional area of the vas deferens on the operated compared to the control side. However, there was no difference in the other groups and there was no significant difference in s-testosterone levels between the groups. There was significantly more inflammation and fibrosis after mesh repair compared to suture repair, but there was no difference between the two mesh groups. Unexpectedly, polyglactin fibres were still seen in specimens in group III after 90 days. Conclusion: In conclusion, the only effect on the spermatic cord structures in a rat model is seen as an impaired s-testosterone production and a reduced cross-sectional area of the vas deferens after use of a low-weight composite mesh compared to the control side. No difference in inflammation or fibrosis was found between heavyweight polypropylene mesh and low-weight composite mesh.

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Randomised study of Lichtenstein compared with Shouldice inguinal hernia repair by surgeons in training

Abstract: For surgeons in training the Lichtenstein open mesh technique is a better method of inguinal hernia repair than the Shouldice technique. The outcome is better for the patients and it is more cost-effective.

Cited by 82 publications

References 7 publications

Short-term results of a randomized clinical trial comparing Lichtenstein open repair with totally extraperitoneal laparoscopic inguinal hernia repair

Short-term results of a randomized clinical trial comparing Lichtenstein open repair with totally extraperitoneal laparoscopic inguinal hernia repair

Desarda’s versus Lichtenstein technique of inguinal hernia repair

Does Mesh Implantation Affect the Spermatic Cord Structures after Inguinal Hernia Surgery?

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