O27 THE IMPACT OF NERVE MANAGEMENT ON THE RISK FOR PERSISTING POSTOPERATIVE PAIN FOLLOWING OPEN ANTERIOR MESH REPAIR OF INGUINAL HERNIA

Aim The impact of peripheral nerve management on post-operative pain is poorly known. The aim was to evaluate how management of the inguinal nerves during anterior mesh hernia repair affects the risk for long-term postoperative pain. Material and Methods Cross-sectional study based on the Swedish Hernia Register (SHR). Includes patients over 18 years of age with an open anterior repair during 2012-2018, who responded to a one-year follow-up questionnaire regarding pain. Ordered logistic regression analysis was applied to determine risk factors for pain. Results In total 35,720 patients who were operated with anterior mesh repair responded to the PROM questionnaire. Overall, 15.6% reported pain interfering with daily activities. The risk for persisting groin pain one year after surgery was not impacted by transecting the iilioingiounal nerve (0.49), the iliohypogastric nerve (0.17) or the genital branch of the genotiofemoral nerve (0.25) in a multivariable ordinal regression adjusting for anaesthesia, gender, age and emergency surgery. Conclusions Intraoperative management of the three main inguinal nerves was not associated with the risk for persisting pain in the operated groin one year after surgery.

Desarda Versus Lichtenstein Repair for Primary Inguinal Hernia in Men: Results of A Randomized Control Trial

Inguinal hernia is a very common surgical problem for which mesh based technique particularly Lichtenstein repair is considered as standard. However, it is not free from some major and bothersome complications. Desarda technique of non-mesh hernia repair invented by the Indian surgeon is claimed as low cost tension free procedure with promising results. The objective of the study is to evaluate the feasibility of Desarda procedure in country like Bangladesh as a treatment of primary inguinal hernia in men by comparing with Lichtenstein repair in terms of various parameters. One hundred and sixty male patients between ages of 18-70 years with uncomplicated primary inguinal hernia were initially randomized to perform the one of the two procedures in every alternate patient. Outcome were measured and analyzed. A total of 100 patients were finally studied with a follow up of 2 years. Operative time and immediate postoperative pain were significantly less in Desarda arm. Cost and foreign body sensation were also in favour of Desarda group. There was no recurrence in either group. Desarda repair is easy to perform and takes less time. It is cost effective with a comparable clinical outcome to standard Lichtenstein repair at least in short term. Faridpur Med. Coll. J. Jan 2019;14(1): 20-26

Hydrophilic and degradable polyesters based on l-aspartic acid with antibacterial properties for potential application in hernia repair

A polyester hernia patch has received extensive attention in mesh hernia repair.

Recurrence Rates and Mesh Shrinkage After Polypropylene vs. Polyester Mesh Hernia Repair in Complicated Hernias

Prosthetic mesh implants in hernia repair are frequently used based on the fact that lower recurrence rates are detected compared to anatomic repair. In latest years, researchers tried to answer weather there is an ideal mesh material for abdominal hernia repair. The studies tried to compare resistance, bio-tolerance, rates of recurrence and infection of several materials used in alloplasty. The results are far from pointing an unique ideal chemical structure of mesh. In our study, we compared the results of a cohort of 265 patients operated in 2010 and 2011 in our clinic for complicated abdominal incisional hernias. We compared the results of polypropylene mesh vs. polyester. Polypropylene mesh proved significantly better for preventing hernia recurrence and showed a lower shrinkage rate.