A STUDY OF POSTOPERATIVE COMPLICATIONS FOLLOWING OPEN MESH INGUINAL HERNIA REPAIR

Abstract

Abdul Kalam1, Meena Ashokan2, Baiju3, Sunil Kumar4

BACKGROUND
Inguinal hernia is the most common type of hernia. Inguinal region consists of deep inguinal ring, inguinal canal and superficial inguinal ring, which make the region weak and susceptible to hernia. 65% of inguinal hernias are indirect hernias and 35% direct hernias.
Hernioplasty is the strengthening of posterior wall of inguinal canal. It can be done either with the help of mesh repair or darning. Hernioplasty is indicated in recurrent hernia cases, inguinal hernia with weak abdominal muscle tone where mesh plasty is preferred and inguinal hernia with good muscle tone where darning can be done.
In mesh repair, posterior wall (Lichtenstein repair) of inguinal canal is strengthened by a Prolene or Marlex mesh. Over time, fibroblasts and capillaries grow over the mesh converting it into a thick sheath strengthening the posterior wall.
Complications which can be encountered postsurgery are pain, bleeding, urinary retention, scrotal swelling, abdominal distension, seroma and wound infections, chronic pain, keloid and testicular atrophy.
MATERIALS AND METHODS
? The study was conducted in the Department of General Surgery, Travancore Medical College, Kollam.
? The study was done from January 2015 to January 2016.
? One hundred cases were identified and were chosen for the study.
INCLUSION CRITERIA
1. Inguinal hernia cases treated by open mesh repair.
EXCLUSION CRITERIA
1. Other types of inguinal hernia repair.
RESULTS
All the cases studied belonged to male sex.
In our study, age group twenty to forty years amounted to sixty one cases followed by age group forty to sixty years, which amounted to twenty eight cases. Age group zero to twenty years amounted to six cases and age group more than sixty years amounted to five cases. In the study group, seventy two cases were indirect inguinal hernias and twenty eight cases were direct inguinal hernias.
Based on the complications encountered, pain at the site was the commonest complaint, which amounted to eleven cases, seroma was seen in seven cases, in six cases scrotal swelling was seen, two cases developed keloid at the scar site, wound dehiscence, infection, bleeding from site amounted to one case each.
CONCLUSION
Open mesh repair for inguinal hernia is a safe method of operation. Newer laparoscopic mesh repairs are on the rise, but they need expertise and there is a learning curve.

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