A clinical study of inguinal hernia with special reference to laparoscopic trans-abdominal pre peritoneal repair

Abstract

Background:Hernia may be generally defined as the protrusion of an abdominal viscus outside the abdominal cavity through a natural or acquired defect. Latin meaning of the word “hernia” is tear or rupture. A Clinical study on inguinal hernia is undertaken to assess the incidence of inguinal hernia in relation to age, gender and occupation, the different types and modes of clinical presentation of patients, the management of patients with special consideration to laparoscopic (TAPP) repair, to evaluate the operating time, pre-operative and post-operative complications, duration of hospital stay, time taken for recovery, recurrence rate and limitations with respect to laparoscopic TAPP repair.Methods: This is a prospective study of 54 cases of inguinal hernia admitted and underwent surgery for inguinal hernia in Department of General Surgery in Guwahati Medical College and Hospital during the study period of August 2014 to July 2015.Results:The highest number of cases presenting with inguinal hernia were over 45 years and it was more common in males which constituted 96.3 percent of cases. It is more common on right side and indirect hernia is more common than direct hernia. The major possible risk factors are smoking and strenuous work. The commonest presenting mode was swelling followed by swelling with pain. The mean time taken for TAPP was 91.85±15.85 minutes and the median time was 87.50 minutes. There were no intra operative (neurovascular, visceral) complications in any of the patient and there was no conversion to open surgery. There was no mortality in present study and none of the patient had any testicular complication.Conclusions:Laparoscopic hernia repair is associated with steep learning curve for surgeons and is more costly both to patients and health care system in the present scenario. Laparoscopic TAPP hernia repair is found to have encouraging results which is a safe and viable option for repair of inguinal hernia with less postoperative pain and discomfort, improved cosmesis, less post-operative complications and early return to work.