A Prospective Comparative Study of 3-Stitch Mesh Hernioplasty with Conventional Lichtenstein Repair

Pankaj Kumar Sharma; Manish Khandelwal; Dharmendra Kumar Pipal; Yatindra Singh; Saurabh Kothari; Vijay Verma; Seema Yadav; Bhupendra Singh; Gurusha Jangid

doi:10.4103/jwas.jwas_49_23

A Prospective Comparative Study of 3-Stitch Mesh Hernioplasty with Conventional Lichtenstein Repair

J West Afr Coll Surg. 2023 Oct-Dec;13(4):67-72. doi: 10.4103/jwas.jwas_49_23. Epub 2023 Sep 16.

Authors

Pankaj Kumar Sharma¹, Manish Khandelwal¹, Dharmendra Kumar Pipal², Yatindra Singh³, Saurabh Kothari⁴, Vijay Verma³, Seema Yadav⁵, Bhupendra Singh⁶, Gurusha Jangid⁷

Affiliations

¹ Department of General Surgery, Government Medical College, Kota, Rajasthan, India.
² Department of General Surgery, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India.
³ Department of General Surgery, Dr S N Medical College, Jodhpur, India.
⁴ Department of General Surgery, Geetanjali Medical College and Hospital, Udaipur, India.
⁵ Department of Anesthesiology, JNU Medical College and Hospital, Jaipur, Rajasthan, India.
⁶ Department of Anesthesiology, All India Institute of Medical Sciences, Raebareli, Uttar Pradesh, India.
⁷ Dr S N Medical College, Jodhpur, Rajasthan, India.

Abstract

Background: Hernioplasty, in which a mesh is used to strengthen a weakness or defect in the inguinal wall, has replaced simple tissue repair. As it is associated with low recurrence, it is considered the gold standard and is one of the most common general surgical procedures. The ideal repair should be rapid, safe and simple to do, requires minimal dissection to create sufficient space, be cost-effective and be accompanied by a brief hospital stay, reduced pain, and fewer recurrences. The aim of the present study was to compare the efficacy of 3-stitch mesh fixation with that of traditional Lichtenstein mesh fixation of inguinal hernia repair.

Materials and methods: Between July 2018 and December 2019, 59 cases of primary, uncomplicated inguinal hernias were surgically treated. Both the classical Lichtenstein technique (group A, n = 30) and the Lichtenstein technique with the three-stitch fixation method (group B, n = 29) were used on patients with inguinal hernias. Between the two groups, the mean operative times, post-surgical pain scores, average hospital stays and postoperative complications including recurrence rates were compared.

Results: With a P-value of 0.001, the 3-point fixation group (group B) took 3.41 ± 0.58 min less time to fix the mesh than the Lichtenstein group (group A, 5.52 ± 0.59 min). The pain after surgery was much less for participants who had 3-point mesh fixation than for those who had conventional mesh fixation in the early (1, 3, 7 and 15 days after surgery) and late (1 month and 3 months) postoperative periods, with a P-value of 0.0001. When compared to the classical mesh fixation group, the 3-point mesh fixation group had less urinary retention, seroma and swelling. Both groups had the same number of other complications.

Conclusions: The three-point hernioplasty is a simple procedure that is easier to adopt, less time-consuming, causes less trauma and has a lower risk of postoperative discomfort including chronic groin pain.

Keywords: 3-point mesh repair; Lichtenstein hernioplasty; chronic groin pain; inguinal hernia; recurrence.