A comparative study of inguinal hernia repair: Shouldice versus Lichtenstein repair

Background: Inguinal hernia is a common problem and its repair is one of the most frequently performed operation in general surgical practice. There are appreciable advantages of Lichtenstein over Shouldice repair in terms of simplicity, less time consuming and postoperative pain; there in the context of less developed countries with limited economic resources, however Shouldice repair is more cost effective and there are no differences in recurrences and other complications which would be a better proposition. The present study aims at comparing the results of Shouldice versus Lichtenstein’s repair in inguinal hernia in adult male (≥18 years).Methods: Total of fifty cases was included in this study, were equally divided into 2 groups; Group A and Group B and subjected for Shouldice and Lichtenstein mesh repair respectively. Operating time, postoperative complications as Wound infection, Seroma, Hematoma, Postoperative pain, and days of hospital stay, total costs and time to return to usual activity was noted.Results: Out of 50 patients, 36 (72%) were had indirect hernia and most of them were in between 18-29.9 years of age. There were no difference between two groups with respect to postoperative pain, Wound infection 12% and 8%, Seroma 8% and 4% and Hematoma 4% and 4% in Group A and Group B respectively. However, there is significant difference noted in operating time period in which Shouldice repair took more time (Mean time in Shouldice 84.16 min and Lichtenstein 58.80 min). There were no recurrences in either group.Conclusions: So, comparing our results of both groups, Lichtenstein repair were found to be better as it is simple procedure and is less time consuming than Shouldice repair. However, Shouldice repair was found to be cost effective which could be an important consideration in developing countries.

Modified shouldice repair of bilateral inguinal hernia with hydrocele: A case report

Indirect inguinal hernia is a common medical condition that can be caused by an embryological defect due to failure of closure of processus vaginalis that can lead to herniation (i.e. abnormal protrusion) of abdominal contents into scrotal sac in males. In this paper, we describe an interesting case report of a patient with bilateral inguinal hernia with hydroceles who underwent a modified shouldice repair. In addition, we also discuss initial presentation & surgical management of this patient who had painless postero-inferior displacement of testes. Reason why we think this case is unique, is because of ‘bilateral’ hydroceles along with bilateral inguinal hernia which is rarely seen as compared to its unilateral counterparts. We also describe various surgical steps of modified shouldice repair with bilateral orchiopexy along with the post-operative outcome. Finally, we also discuss various types of hydroceles, along with its pathology that is found after surgical resection.South East Asia Journal of Public Health Vol.7(1) 2017: 62-65