Comparison of Hernia Sac Ligation Versus Invagination
Study Details
Study Description
Brief Summary
Management of indirect hernial sac in inguinal hernia repairs has long been a subject of debate among general surgeons. Although hernial sac high ligation (HL) is a time-honored concept in groin hernia surgery, non-ligation/invagination is gaining more popularity. The aim of this study is to compare the effects of hernia sac ligation and invagination in patients with Lichtenstein mesh hernioplasty (LMH). Also, investigators aimed to investigate the possible association between the hernial defect size and postoperative early pain in both groups.
Condition or Disease | Intervention/Treatment | Phase |
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N/A |
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Active Comparator: high ligation High ligation of the indirect hernia sac is traditional in inguinal hernia repairs. In this arm, patients with indirect inguinal hernia undergoing open mesh herniorrhaphy will have their hernia sac was opened and high ligated. |
Procedure: Lichtenstein Mesh Hernioplasty
The inguinal canal was opened and the hernia sac was dissected from the spermatic cord The deep inguinal ring was tightened with one or two polypropylene 2/0 sutures. The posterior wall of the inguinal canal was supported using the standard polypropylene mesh and fixed with 2/0 polyproline. The ilioinguinal nerve, iliohypogastric nerve, and genital branch of the genitofemoral nerve were preserved and care was taken to prevent entrapment.
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Experimental: non-ligation In this arm, the patients' hernia sac will be dissected high but not opened or ligated. The sac will be invaginated to the abdomen. |
Procedure: Lichtenstein Mesh Hernioplasty
The inguinal canal was opened and the hernia sac was dissected from the spermatic cord The deep inguinal ring was tightened with one or two polypropylene 2/0 sutures. The posterior wall of the inguinal canal was supported using the standard polypropylene mesh and fixed with 2/0 polyproline. The ilioinguinal nerve, iliohypogastric nerve, and genital branch of the genitofemoral nerve were preserved and care was taken to prevent entrapment.
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Outcome Measures
Primary Outcome Measures
- postoperative pain levels [postoperative period before discharge-1 year after discharge]
10-point Visual Analogue Scale (VAS)
Secondary Outcome Measures
- postoperative complications [postoperative period before discharge (mainly the first 24 hours)]
hematoma, seroma, wound infection, urinary retention
- perioperative outcomes [postoperative period before discharge (mainly the first 24 hours)]
operative time (minutes), hospital stay (days)
- recurrence [postoperative 1 year]
Number of patients with hernia recurrence
Eligibility Criteria
Criteria
Inclusion Criteria:
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unilateral uncomplicated indirect hernia
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elective operations
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spinal anesthesia
Exclusion Criteria:
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Bilateral hernias
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recurrent cases
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femoral-scrotal hernias
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those who refused to give consent
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those who were given general anesthesia besides spinal anesthesia
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those who were repaired with a method other than Lichtenstein mesh hernioplasty
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Samsun Eğitim ve Araştırma Hastanesi | Samsun | Turkey | 55090 |
Sponsors and Collaborators
- Samsun Education and Research Hospital
Investigators
- Principal Investigator: Ahmet Burak Ciftci, Samsun Education and Research Hospital
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- SamsunERH2020