Scrotal hitch: a novel technique to reduce post-operative scrotal oedema in inguinal hernia surgeries: a pilot study

Background: Inguinoscrotal swellings are the most common presenting complaints in the surgical out patient department and surgeries for the same are the most commonly done elective procedures.However meticulous the surgeon is, there is always some amount of scrotal oedema. Our study is intended to use a simple and novel technique by applying a scrotal hitch after the surgery to prevent the scrotal oedema. The aim of the study was to evaluate the effectiveness of a scrotal hitch in reducing the scrotal oedema and pain postoperatively.Methods: In this study all subjects undergoing inguinal hernia surgeries at undergoing at R.L. Jalappa Hospital, Kolar from June 2019 to August 2019 were included. Of the 60 subjects, 30 in group A were given scrotal hitch and subjects in group B were given scrotal support alone. The incidence of scrotal oedema and postoperative pain and development of any complications will be compared in both the groups.Results: A total of 60 subjects were included in this study. Mean age of patients in group A is 45.63±21.745 and group B is 41.43±24.579. 2 patients with scrotal hitch developed scrotal edema whereas 6 patients developed scrotal edema in group B. The post-operative pain score was lower in patients with scrotal hitch.Conclusions: Scrotal hitch is a simple and effective technique in preventing post-operative oedema and pain. The results of this study would encourage surgeons to take up this simple procedure to prevent the commonest complication of inguino-scrotal surgeries.

Spigelion hernia: fascia lata repair is an alternative option in absence of prolene mesh.

Spigelian hernia is rare. Seven cases of Spigelian hernia are presented. These include two recurrent Spigelian hernias. Incisional hernias through Spigelian aponeurosis after Pfannensteil incision are not included. Clinical examination is the mainstay of diagnosis. The true incidence is possibly higher, as a low Spigelian hernia is not recognised and often diagnosed as a direct inguinal hernia. Ultrasound scanning is recommended, as it is non-invasive and easily available and can detect the hernial orifice in the Spigelian fascia at an early stage. Recurrence of Spigelian hernia took place in two cases through the site of prolene stitch of a previous repair. Hernioplasty with tension free fascia lata graft/prolene mesh was carried out in all cases. The cost of fascia lata graft is only a scar in the thigh. In a mean follow-up of 3.1 -year no patient has reported back with recurrence This is the ideal substitute for the patients in developing countries where synthetic meshes are still not freely available.