Fixation Versus No Fixation of Prolene Mesh in Lichtenstein Mesh Hernioplasty for Inguinal Hernia: A Short-term Follow-up Study

Abstract

Introduction: Lichtenstein tension free repair is the most commonly used anterior technique in which mesh is used for inguinal hernia. Aim: To compare fixation vs no fixation of prolene mesh in Lichtenstein mesh hernioplasty for inguinal hernia. Materials and Methods: This prospective interventional study was conducted in the Department of General Surgery at Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India, between December 2019 and May 2021. Patient of either sex aged 18 to 70 years who had reducible inguinal hernia were divided into two groups (group A: no mesh fixation and group B: mesh fixation by Lichtenstein mesh hernioplasty). Operative procedure time, postoperative pain (using visual analogue pain scale), postoperative haematoma/seroma, wound infection and rate of early recurrence were assessed. Operative procedure time and postoperative pain in both group was compared in both group using student’s unpaired t-test with unequal variance while postoperative haematoma, postoperative recurrence and mesh migration were compared in both group using Fischer’s-Exact Test. Results: A total of 89 patients were enrolled (group A has 48 patients and group B has 41 patient). Operative procedure time was less in group A in comparison to group B which was statistically significant (p-value= 0.00221). Postoperative mean pain score was lower in group A at 12 (5.85 vs 6.97), and 24 hours (5.79 vs 7.19), and at day 2 (5.12 vs 6.61), day 4 (4.33 vs 5.1), day 7 (3.67 vs 4.56) and at 1 month (3.1vs 3.58). Postoperative haematoma/seroma was found less in group A but was not significant. Recurrence and mesh migration were seen in one patient in group A. Conclusion: No prolene mesh fixation technique in Lichtenstein mesh hernioplasty had decreased postoperative pain with an added benefit of lesser in operative time.