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Inguinal Hernia Repair: Are our practices current? Introduction: Repair of inguinal hernia is a common surgical procedure, but the most effective surgical technique remains debatable. Our observation showed that most hernia at our institution are tissue repairs (Bassini) as opposed to mesh repairs (Lichtenstein or laparascopic). The practice of surgery based on evidence has proved that long term outcome of hernia repair is improved by the techniques which employ tension free mesh repair. Methods: All adult hernia repair done at the Aga Khan University Hospital in the proceeding two years by all surgeons with admitting privileges were reviewed. The method of repair was noted, as was the length of hospital stay. A questionnaire was also availed to the admitting surgeons to indicate their preferred method, and this was correlated with the audit results. A search of the literature was reviewed to establish current recommendations for the most efficacious repair. Results: One hundred and seventy four hernia repairs were reviewed. 58 (33.72%) were left sided, 95 (54.07%) were right sided and 21 (12.21%) were bilateral. The most common method of repair was tissue (Bassini) done in 99 herniae (56.9%). Open mesh repair (Lichtenstein) was done in 67 herniae (38.5%) and laparascopic repair in 8 hernia (4.6%). The mean hospital stay for the tissue repair was 2.4 days (range 1 – 18 days), mesh repair 2.3 day (range 1-6 days) and laparascopic rapair 2.9 days (range 1-11 days). Majority of patients with open mesh repair stayed for only one day in hospital (52.24%) as compared to the tissue repair (26.26%) or laparascopic repair (37.5%). Conclusion: Tissue repair is still widely practiced at out institution by the surgical fraternity despite easy availability of mesh. The use of mesh should be encouraged as the standard of care for hernia repair. “No idea is wholly new; what is new is getting people to adopt and act upon it”. |
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