Pre-peritonial Repair for Recurrent Inguinal Hernia after Tension free Hernioplasty

Background: Inguinal herniorrhaphy is a common general surgical operation. The repair of recurrent hernia is difficult surgery due to obscured and distorted anatomy and risk of further recurrence. The aim of this study is to determine the outcome in terms of operative time, hospital stay, return to work, complications and recurrence of open pre-peritoneal repair for recurrent inguinal hernias after Lichtenstein tension-free hernioplasty. Materials and Method: It is a prospective observational study conducted at Western Regional Hospital, Pokhara from 2013 to 2016. A total of eight patients including referred from other centers were included. Pre-peritoneal repair was performed on recurrent hernias after Lichtenstein tension-free hernioplasty. Age, sex, operating time, hospital stay, time to return work, postoperative complications and recurrence of patients were noted. Statistical analysis was done using SPSS- 21. Patients were called for follow up in 2 weeks, 3 months and 12 months time. Results: Out of eight patients, seven were male, one was female with mean age of 59.5 years. Recurrence was common on direct inguinal hernia (six patients) who had previous Lichtenstein hernioplasty. Mean operative time was 43.13 minutes (35 to 50 minutes), mean hospital stay was 2.5 days (2 to 4 days) and mean time to return to work was 8.12 days (7 to 10 days). There was hematoma formation in one patient. Conclusion: Pre-peritoneal mesh repair is easy, safe, with less operative time, short hospital stay, low recurrence and complication rate for recurrent inguinal hernia after Lichtenstein hernioplasty.