外科ジャーナル

Open Pre-peritoneal Mesh Repair for Groin Hernia-Experience from a Rural Regional Hospital in Western Australia

Abstract

Abdallah Elsabagh*, Chang Mien-Chew and Thomas Bowles

Background: Pre-peritoneal mesh repair for inguinal hernia is a minimally invasive open technique that has become an alternative to laparoscopic groin hernia repair. It mimics the laparoscopic repair for tension-free, preperitoneal herniorrhaphy, but does not require specialized equipment, thereby decreasing cost. In our study, we evaluated the immediate and long-term outcomes of the preperitoneal mesh repair of inguinal hernia in Albany Regional Hospital Western Australia
Methods: All patients who had pre-peritoneal mesh repair for inguinal hernia by the local two surgeons between 2010 and 2015 were identified and included in the study. The data included patients’ demographics, length of hospital stay, complications; including hematoma, seroma, wound infection, recurrence; and chronic groin pain. All patients were reviewed 4-6 weeks post-operatively in the outpatient clinic. Patients with symptoms or an apparent groin swelling were reassessed by one of the two primary operators. Patients who developed complications were offered longer follow up appointments, otherwise discharged back to GP care. Patients who developed late complications were referred back by the GP.
Result: A total of 435 cases were operated, recorded, analyzed and included in the study. 93% were males, mean age 59 and mean operative time 35 minutes. Patients were seen in the clinic 4 weeks postoperatively, patients with late complications were referred by the GP. Complication were acute urinary retention 3.9%, hematoma 3%, seroma 2.7%, infection was 0.9%, recurrence 2.7%,chronic pain 0.2%.
Conclusion: The open pre-peritoneal inguinal hernia repair is a safe minimally invasive approach and is associated with a low rate of postoperative chronic pain or recurrence.