Trans-inguinal Pre-peritoneal Hernioplasty Versus Lichtnestein's Technique in Inguinal Hernia Repair

Not Applicable

Interventions: Procedure: Trans-inguinal Pre-peritoneal Hernioplasty
Procedure: Lichtnestein's hernioplasty

Brief Summary: Mesh repair of inguinal hernia is the most common operation performed on general surgical patients. Approximately 20 million groin hernioplasties are performed each year worldwide. Countless studies have been reported in the medical literature in attempts to improve the overall outcomes following hernia operations and, due to this fact, the procedure has evolved immensely, especially over the last few decades. Recurrence of inguinal hernia was initially a significant problem. Lichtenstein repair (LR), recurrence rate has consistently been reported as low as 1-4%\[2\], a drop from up to 10%. But increased incidence of chronic groin pain following LR.

Transinguinal preperitoneal (TIPP) inguinal hernia repair with soft mesh has been reported as a safe anterior approach with a preperitoneal mesh position .

Theoretically, TIPP repair may be associated with lesser chronic postoperative pain than Lichtenstein's technique due to the placement of mesh in the preperitoneal space to avoid direct regional nerves dissection and their exposure to bio-reactive synthetic mesh. The placement of mesh in this plane without using any suture for fixation and lack of mesh exposure to regional nerves was assumed to result in the reduced risk of developing chronic groin pain. So aim of our study to prove less hospital stay and complication and cost effectiveness for preperitoneal meshplasty

Detailed Description: This study is a prospective randomized study including all Patients with unilateral non complicated inguinal hernia who will undergo hernioplasty in surgery department at AUH during the period from 3- 2018 to 6- 2020

Methodology:

Patients will be classified into two groups according to the surgical procedure performed as follows:

* Group A: Patients undergoing TIPP hernioplasty

* Group B: Patients undergoing lichtnestein's technique hernioplasty

Sample size:15 patients for each group.

D) Exclusion criteria:

1. Patients who were unfit for operation.

2. Patients with bilateral or recurrent inguinal hernia

3. Patients aged below 18 years,

4. Patients undergoing emergency hernia repairs

Recruitment & Eligibility

Inclusion Criteria

. Patients with unilateral non complicated inguinal hernia who will undergo hernioplasty in surgery department at AUH

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
group A	Trans-inguinal Pre-peritoneal Hernioplasty	Patients undergoing trans-inguinal pre-peritoneal (TIPP) hernioplasty
group B	Lichtnestein's hernioplasty	Patients undergoing lichtnestein's hernioplasty

Primary Outcome Measures

Name	Time	Method
comparison between the 2 techniques regarding presence and duration of post-operative chronic pain	visits will be within 6 months post operative	post operative clinical examination for assessment of the presence and duration of chronic pain

Secondary Outcome Measures

Name	Time	Method
operation time	intra-operative	comparison between the two techniques regarding operative time
Duration of hospital stay post operative	first week post operative	comparison between the two techniques concerning Duration of hospital stay post operation after each procedure
presence of any wound complication by examining the wound	first 2 weeks post operative	comparison between the two techniques concerning presence of any wound complications by wound examination
recurrence rate	6 to 12 month post operative	comparison between the two techniques concerning recurrence rate of inguinal hernia
time needed for the patient to return to work	1 month post operative	comparison between the two techniques regarding needed time to return to work

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