Repair of Adult Inguinal Hernia With Continuous Sutures of External Oblique Aponeurosis

Abstract

OBJECTIVETo study the repair of adult inguinal hernia with continuous sutures of external oblique aponeurosis with respect to its acceptability, effectiveness, outcome and the satisfaction of patients. METHODOLOGYThe observational study was conducted from August 2008 to September 2010 in Surgery Unit IIA of the Department of General Surgery, Regional Institute of Medical Sciences, Hospital, Imphal. Adult patients with inguinal hernia (18-75 years) were admitted and treated with continuous sutures of external oblique aponeurosis as originally described by Desarda in 2001. RESULTSThere were 54 patients -51 males (94.44%) and 3 females (5.6%). Age of the patient's ranges from 18-75 years (Mean age of 53.9 years). Out of the 54 patients, 32 patients (59.3%) were having indirect inguinal hernia, 19 patients (35.2%) with direct inguinal hernia and 3 patients (5.6%) had combined direct and indirect inguinal hernias. Right sided hernia was seen in 37 patients (68.5%) and left sided hernia in 17 patients (31.5%); 47 patients (87.03%) were operated under Spinal Anaesthesia (SA) and 7 patients (12.96%) under epidural anaesthesia. Adhesions were found in 5 cases (9.26%), four patients (7.41%) had transient wound oedema, 3 patients (5.6%) had pus collection followed by drainage, 3 (5.6%) patients had wound haematoma, which subsided by itself and 2 (3.70%) had seroma formation which required regular dressing. During the follow-up period, no hernia recurrence was encountered. Majority of the patients had mild-to-moderate post-operative pain, which was easily managed with analgesics. The hospital stay was short, thus allowing the patients a quicker return to activity. Majority of the patients (40, i.e. 74.07%) were discharged on the 3rd post-operative day. Majority of the patients were satisfied with the operation. CONCLUSIONRepair of adult inguinal hernia with continuous sutures of external oblique aponeurosis is safe and effective in terms of postoperative pain, return to work, recurrence, cost effectiveness and can be the preferred choice for open repair of adult ingui nal hernias.