European Journal of Molecular & Clinical Medicine

The inguinal hernia is one of the most common surgical procedures performed by General Surgeons worldwide. The lifetime incidence of inguinal hernia is 27% in males and 3% in females. Inguinal hernias are one of the commonest problems encountered by the treating phsicians. Even though the learning curve for Lichtenstein hernioplasty is less, there is usage of a foreign body which may produce mesh reactions leading to various other surgical complications. Also the cost of the mesh is a little higher which may not be affordable for people belonging to low or very low socioeconomic class especially in developing countries like India. Desarda’s repair is a tissue based technique of hernia repair using an undetached strip of external oblique aponeurosis to strengthen the posterior wall of the inguinal canal.

Inguinal hernia repair is one of the more common types of surgeries performed. With appropriate techniques, the block provides excellent intraoperative anaesthesia and postoperative analgesia for hernia repair, thereby simplifying anaesthetic surveillance and postoperative care.
Aim and Objectives: To study the effectiveness of field block anaesthesia for inguinal hernia repair in our tertiary care settings.
Material and Method: A clinical study was undertaken for anaesthetising 50 patients aged between 18-60 years of age posted for elective inguinal hernia repair, consenting and co-operative for inguinal field block. Study was conducted at our institute for the period of one year, after getting consent from patients, approved by institutional ethical committee and followed inclusion and exclusion criteria
Results : Study included 50 patients, with mean of age was 39.36 years with SD of 12.68. All patients were hemodynamically stable throughout procedure and surgery. 36 patients had a excellent type of analgesia and relaxation. 8 patients complained of discomfort during surgical handling of the hernial sac or hernia repair. 4 patients were not comfortable with the above measures and needed fentanyl depending upon their body weight. 2 patients had no analgesia Conclusion:  Field block is effective technique of anaesthesia for inguinal hernia repair and it provides good quality of analgesia and relaxation intraoperatively.

Introduction: Regional Anaesthesia is the most common and preferred technique for elective inguinal hernia surgeries. The most commonly used anaesthetic agent for spinal anaesthesia are Lidocaine and Bupivacaine. Ropivacaine is an alternative to Bupivacaine due to its lesser degree and duration of motor blockade, good hemodynamical stability and lesser systemic toxicity. Hence this study was conducted to find out the efficacy and side effect profile of the Ropivacaine against the bupivacaine for elective inguinal surgery as part of day care surgery.
Material and Methods: This present study was a prospective study conducted at tertiary health care hospital on 80 patients undergoing elective inguinal hernia surgery divided into two groups, Group R – receives 3 ml of isobaric ropivacaine 0.5% with 0.5 ml of Fentanyl which contains 25 micrograms and Group B – receives 3 ml of hyperbaric bupivacaine 0.5% with 0.5 ml of fentanyl which contains 25 micrograms. Sensory and motor blockade were assessed along with duration and the analgesia

In our country, a large part of patients still neglects inguinal hernia due to the low level of public awareness about the danger of obstruction and strangulation. Even with better pre and postoperative care, improved anesthetic management and advanced surgical techniques, the emergency repair of an obstructed hernia is associated with poor prognosis and a high rate of postoperative complications. This study is to assess various risk factors and therapeutic strategies for better outcome of the patients presented with an obstructed inguinal hernia at our setup. A total of 74 inguinal hernia patients with obstruction were evaluated. Majority of the patients were in the fifth and sixth decade. More than 50% of cases belong to low socio-economic strata, who do heavy work. Right-sided Indirect hernias were more common than others. Chronic cough, constipation, prostatic enlargement are common causes of increased intra-abdominal tension seen in more than 60% of cases. All of the cases were operated as an emergency procedure. Viable bowel was seen 75.46% of cases. Bowel resection and end-to-end anastomosis were done in all cases of nonviable bowel. Patients presented early with the only obstruction, had an excellent prognosis; But the danger group, where symptomatology is vague and associated with strangulation had a higher rate of complications and mortality.

Background:Inguinal Hernias are among the most common clinical entities requiring surgical intervention in general surgery. Aim: To analyse the different surgical approaches chosen for the inguinal hernia repair in the rural areas of the third world country, the complications thereof and the hospital stay retrospectively. Methods: 365 patients presenting to the hospital between November 2017 to November 2019 were analysed for the surgical intervention in inguinal hernias. Results: 349 patients out of 365 underwent the open surgical intervention and 16 were dealt laparoscopically. Average duration of 45 minutes to 1 hr and 1 hr 45 minutes to 2 hrs was noted in open and laparoscopic method respectively. Recurrence was seen in 2 cases which had undergone open method. : 4 cases of wound infection were noted, out of which mesh removal was done in 1 case. Conclusion: Open surgery is the preferred method of surgical intervention in socially backward area

Background: Inguinal hernia repair has often been used as a showcase to illustrate practice variation in surgery. This study determined the degree of hospital variation in proportion of patients with an inguinal hernia undergoing operative repair and the effect of this variation on clinical outcomes.
Method: An unselected cohort of 223 patients who underwent laparoscopic totally extraperitoneal (TEP) inguinal hernia repair before March 2022 were included in this study, thus ensuring a minimum 5-year follow-up. Patient demographic data, clinical notes, operating notes and outpatient follow-up notes were studied. Patients were interviewed telephonically regarding hernia recurrence, chronic pain and technique preference if they had previously undergone an open repair. All data collected were recorded on an electronic spreadsheet.The primary outcome parameter was recurrence. The secondary outcome parameters were postoperative and long-term complications.
Results: This nationwide database study shows that practice variation in inguinal hernia repair is modest in the Babel province. Operation-rates vary by less than two-fold, and variation is stable over the years 2020-2022. A more thorough analysis illustrates that the type of hospital (academic, teaching, or private) is the most relevant factor contributing to the observed variation. An addition to previous reports on practice variation in hernia surgery is the present finding that adjusted rates in surgery in general hospitals are associated with the type of financial reimbursement for diagnosis and the percentage of self-employed staff. These non-clinical factors related to variation may not only contribute to practice variation in hernia surgery,
Conclusion :Hospital variation in inguinal hernia repair in the Al-hila city is modest, operation-rates vary by less than two-fold, and variation is stable over time. Hernia repair in hospitals with high adjusted rates of inguinal hernia repair are associated with improved outcomes.

Background:Inguinal hernias are common, and although the results of surgical repair
are often satisfactory, postoperative recovery may be slow, and the hernia may recur.
The present study compared Rutkow–Robbins and Gilbert Double Layer Graft
Methods of hernia repair.
Materials & Methods: 60 patients of inguinal hernia of both genders were divided into 2
groups of 30 each. Group I were treated with Rutkow–Robbins method and group II
with Gilbert double layer graft methods. Parameters such as VAS and complications
were compared
Results: There were 18 males and 12 females in group I and 11 males and19 females in
group II. Anesthesia used was local in 16 in group I and 10 in group II, general 6 in both
groups and spinal 8 in group I and 14 in group II. The mean hospitalization (days) was
2.24 in group I and 2.31 in group II and operation time (mins) was 26.2 in group I and
24.6 minutes in group II. The mean VAS was 1.91 and 2.14 at day 1, 0.84 and 1.21 at
day 7 and 0.09 and 0.27 at day 30 in group I and II respectively.
Conclusion: Both methods of inguinal hernia repair was comparable

Background: The aim of the study is to compare the treatment outcomes of surgical repair in
inguinal hernia with classic versus preperitoneal methods on reduction of postoperative
complications.
Methods: The present study included 100 patients out of which 60 were males and 40 were
females. Both the techniques were explained to the patients.
Results: The rate of recurrence was 4 in the classic group and 3 in the preperitoneal group.
The frequency of postoperative pain was 12 in the classic group and 7 in the preperitoneal
group. This difference was significant according to Chi-Squared test
Conclusion: It can be concluded that the preperitoneal method is a more suitable method for
inguinal herniorrhaphy than the classic one because of fewer complications, according to the
findings of this study.

Background: This prospective, randomised control experiment was conducted to determine the role of single-dose antibiotic prophylaxis after hernia surgery. This research also provides evidence for determining whether stringent aseptic precautions can reduce antibiotic use.
Materials and Methods: This study included 60 patients with inguinal hernias (direct or indirect) who were admitted to the surgical ward at the Pt. B.D. Sharma Post Graduate Institute of Medical Sciences in Rohtak. Prior to admission, each patient was given a thorough screening as well as a rigorous clinical evaluation that included Haemoglobin, Bleeding time, Clotting time, Urine complete examination, Blood urea, Blood sugar, Serum electrolytes, Chest X-ray and ECG.
Results: The average age of the presenters was 45.88 years old. The majority of the patients, sixteen (26.66 percent), were between the ages of 41 and 50. The youngest patient was an 18-year-old man, while the oldest was an 80-year-old man. Males made up 98.33% (n=59) of the cases, while females made up 1.66 percent (n=1). Lichtenstein's repair was performed in forty patients (66.66%) for indirect inguinal hernias, and Lichtenstein's repair was combined with posterior wall plication in eighteen patients (30%) for direct inguinal and Pantaloons' type hernias. Indirect inguinal hernias accounted for the most occurrences (40), with two having a sliding component.
Conclusion: There is substantial evidence in the international literature to support the claim that prophylactic antibiotic treatment does not reduce the incidence of wound infection. Given the findings of this study, it is possible to conclude that the variations in infection rates are not substantial, and that prophylactic antibiotics do not reduce the rate of SSI in mesh repair of inguinal hernias, and that routine use of prophylactic antibiotics is not indicated.

The present study was aimed to compare the complications percent in repair of mesh to tension
free repair of Darn. Methods: 127 patients from 20-66 years old, including 93 (73.2%) male and
34 (26.8%) females, reported for direct and indirect inguinal hernia with open
Mesh/Lichtenstein (58 patients) or Darning repair (69 patients) in Khanagin general hospital
and Jalawla general hospital from February 2017 to February 2020. The first point was to
compare hernia recurrence with two types of technique. Results: Complications of recurrence in
Lichtenstein repair were 1 patient (1.7%) with compared to darning repair which had a
recurrence of 3 patients (4.34%). also, 3 patients (4.34%) got seroma in the darning repair
technique while 2 patients (3.45%) in the mesh repair technique. Hematoma was appeared in 1
patient (1.45%) in darning repair group and nil in the mesh/Lichtenstein repair group. 2
patients (2.90%) treated by darning repair suffered from chronic pain while 1 patient (1.7%)
suffered from chronic pain in mesh/Lichtenstein repair group. Conclusion: mesh/Lichtenstein
repair is very promising in comparison to the other technique, darning repair, in complications
in hernia.