Study of Prolene Hernia Mesh System in Management of Primary Inguinal Hernia Repair

Abstract

BACKGROUND:Inguinal hernia is common disease known to surgeons since ages. Since Bassini first described repairing an inguinal hernia by suturing the conjoint tendon to the inguinal ligament in 1889, the primary surgical objective has been to adequately cover the myopectineal orifice to prevent recurrence. Lichtenstein et al coined the term "tension-free" repair and advocated this approach in 1986. There are different tension free repairs like open anterior (anterior mesh, plug and patch) open posterior approach, laparoscopic posterior patch and Kugel's plug technique. In 1998, the PHS mesh, consisting of an onlay and an underlay patch attached with a connector, was introduced as an option for tension-free open repair of inguinal hernias. DESIGN: The present study of prolene hernia mesh system in primary inguinal hernia repair has been carried out at Indira Gandhi Government Medical College and Hospital, Nagpur between the time period, June 2005 -2007 with a follow up of 5 years. Total 75 cases were studied, operated and followed up for a period of 5 years. Data related to the demographic details, complaints, physical examination findings, intraoperative findings, post-operative stay, complications were collected and analysed. OBSERVATION: After primary inguinal hernia repair with prolene hernia mesh system, 46.66% patients were hospitalized for 3-5 days. Total operative duration required for prolene hernia mesh system repair was 40-60 min in 42.66% cases.42.6% of patients had returned to normal routine work within 1-2weeks of surgery. The complication rate was 16%, which included fever in 3% cases, Seroma in 2.66% cases, haematoma in 1.33% cases and cord oedema in 4% cases, wound infection found in 1.33% patients, chronic groin pain in 2.66% and persistent cord oedema in 1.33% patients. No recurrence was observed in 65 follow up patients. CONCLUSION: The prolene hernia system provides all the advantages of a tension-free repair, including less discomfort, rapid return to normal activity low recurrence rates and minimum postoperative complications.