Changes of abdominal wall mechanics and pain after tension-free inguinal hernia repair with polypropylene mesh / 中国组织工程研究

BACKGROUND: Chronic pain after tension-free inguinal hernia repair is a common postoperative complication. An important cause of chronic pain is nerve injury. OBJECTIVE: To observe the effect of iliohypogastric nerve preposition on chronic pain after inguinal hernia repair and analyze its mechanics. METHODS: Totally 76 male inguinal hernia patients, from August 2013 to November 2016, aged 36-95 years in Second People’s Hospital of Lianyungang were selected. The patients were all treated with large-size polypropylene non-absorbable mesh insertion. The iliohypogastric nerve was placed in front of the mesh. Pain was followed up at 3, 6, and 12 months after operation. This study was approved by the Ethics Committee of Second People’s Hospital of Lianyungang. RESULTS AND CONCLUSION: (1) No chronic pain or recurrence was found in the 76 patients at 3, 6 and 12 months after surgery. (2) The pressure included vertical pressure and tangent pressure formed from intra-abdominal pressure on abdominal wall, directly affecting abdominal wall and artificial repair materials. This was the basic cause of the relative mechanical relationship between nerve and mesh. (3) The results showed that the tension-free inguinal hernia repair with the iliohypogastric nerve preposition could reduce the incidence of postoperative chronic pain, which may be related to the effect of postoperative abdominal pressure on tissue repair, especially the repair around the mesh.

The problems of mesh repair and the value of tissue repair in the treatment of groin hernia in young people / 中国实用外科杂志

The World Health Organization defines youth as 14 to 25 years old, and the inguinal hernia patients in this age group are still in the development stage of the body with special physiological characteristics and special needs for the protection of reproductive functions. Therefore, the repair method should be carefully selected for the special group and the principle of individualized treatment should be adhered to.The synthetic mesh has problems such as failure to extend with body growth, excessive scar hyperplasia compressing the spermaduct, and long-term invasion. The biological patch also has the risk of long-term recurrence or local bulging. For youth, standard tissue repair surgery can mending the defect well, with reasonable perioperative management, also can minimize the discomfort, which caused by excessive early postoperative tension. At the same time, tissue repair can adapt to the growth of the body, with relatively small impact on reproductive function, or can be combined with biological materials to repair large defects if necessary. After mastering tissue repair technology, the recurrence rate of tissue repair is acceptable. Therefore, tissue repair is of irreplaceable value in the treatment of young inguinal hernia patients.

Controversy, consensus and reasonable choice of application of mesh in treatment of inguinal hernia in adolescents / 中国实用外科杂志

The adolescent inguinal hernia has particularity in modern surgical treatment. Because of in the stage of growth and development, it can not be used only for the inguinal hernia sac high ligation, nor can it be treated as an adult inguinal hernia with artificial synthesis material mesh.Therefore, there are still many disputes in adolescent inguinal hernia treatment. As a kind of absorbable material, biologic mesh can repair inguinal hernia defect and induce the growth of cells and fibrous tissue to repair the defect of the inguinal wall. It can be degraded and absorbed by the body after the repair of the defect by the proliferation of autologous tissue,which does not affect the growth and development of adolescents,and its advantages have been affirmed by more scholars. Biologic mesh has become an ideal choice for the repair of inguinal hernia in adolescents.

Clinical comparative analysis of Laparoscopic transabdominal preperitoneal repair and path tension -free ;hernioplasty in the treatment of recurrent inguinal hernia in adults / 中国基层医药

Objective To compare the clinical efficacy of laparoscopic repair of laparoscopic transabdominal preperitoneal(TAPP)and Lichtenstein tension-free repair herniorrhaphy in the treatment of recurrent inguinal hernia in adults,and to explore the clinical advantages of TAPP in the treatment of recurrent inguinal hernia.Methods A retrospective analysis was conducted in 54 adult patients with recurrent inguinal hernia from December 2010 to January 2015.The patients were randomly divided into TAPP group and Lichtenstein group.The operation time,intraoperative bleeding volume,postoperative hospitalization time,cost of hospitalization,postoperative complications,early postoperative pain and the recurrence of hernia were compared between the two groups.Results All patients were successfully completed surgery.The operation time of TAPP group (47.2 ±9.4)min was significantly shorter than (73.1 ±10.4)min of Lichtenstein group (t=-2.503,P=0.034).The median amount of bleeding during operation of TAPP group was 40(15 -110)ml,which was significantly less than 73(11 -130)ml in Lichtenstein group (t=-6.018,P=0.000). Postoperative hospital stay of TAPP group[(6.5 ±1.4)d]was shorter than (8.2 ±1.6)d of the Lichtenstein group (t=-2.613,P=0.028).Early postoperative pain score of TAPP group[(1.8 ±1.2)points]was better than (2.9 ± 1.4)points in Lichtenstein group (t=-7.006,P=0.000),the difference was statistically significant.However,the hospitalization cost of TAPP group[(8 842.8 ±415.2)yuan]was higher than (6 676.9 ±327.6)yuan of the Lichtenstein group,the difference was statistically significant(t=6.782,P<0.05).In TAPP group,2 cases had complications after operation,which were less than 5 cases of Lichtenstein group.Postoperative follow up ranged from 6 to 48 months,1 case of recurrence in Lichtenstein group,the recurrence rate was 3.8%.There was no recurrence in the TAPP group.Conclusion TAPP has the advantages of short operation time,less bleeding,rapid postoperative recovery,less postoperative pain and so on.It can be used as a recommended procedure for the treatment of recurrent inguinal hernia in adults.

Herniation after deep circumflex iliac artery flap: two cases of rare complication / 대한악안면성형재건외과학회지

Herniation after harvesting of deep circumflex iliac artery (DCIA) flap is a known but not a common complication. It occurs about 2.8 to 9 % according to the literatures and can proceed to a more severe complication such as bowel obstruction. There are several factors that exacerbate the risk: surgical factors, operator factor, and patient factors. Surgical factors include large anatomical defect and denervation of related muscles. Operator factor stands for unpunctual suture technique. Patient factors represent obesity, diabetes, pulmonary disease, smoking habits, and so on. Thus, herniation might occur regardless of meticulous suture. Herein, we would like to report two cases of herniation after DCIA flap harvesting and repaired by Lichtenstein tension-free hernioplasty with literature review.

Comparative analysis of transabdominal preperitoneal prosthetic and tension-free hernioplasty in treatment of incarcerated hernia / 中国医师进修杂志

Objective To investigate the security and validity of transabdominal preperitoneal prosthetic (TAPP) in treatment of incarcerated hernia.Methods One hundred and twenty-four patients with incarcerated hernia were divided into 2 groups by random pair method:observation group with treatment of laparoscopic reposition and TAPP (56 cases) and control group with treatment of open reduction and tension-free hernioplasty (68 cases).The operative time,hospital stay,bed time,hospital costs,recurrence rate and complication were compared between the 2 groups.Results All patients in observation group were received laparoscopic surgery successfully.The operation time,hospital stay,bed time in observation group were significandy shorter than those in control group [(37.52 ± 7.78) min vs.(44.23 ± 11.32) min,(4.53 ± 0.89) d vs.(6.85 ± 2.03) d,(9.30 ± 2.65) h vs.(12.63 ± 3.97) h],there were statistical differences (P ＜0.05).The hospital costs in observation group was significandy higher than that in control group [(9 324 ± 599) yuan vs.(7 203 ± 507) yuan],there was statistical difference (P ＜ 0.05).There was no statistical difference in complication rate between the 2 groups (P ＞ 0.05).Follow-up 1 year,there was no recurrence patient in observation group and 1 patient was recurrence in control group,there was no statistical difference between the 2 groups (P ＞ 0.05).Conclusions TAPP is safe and effective with advantages of mini-invasion,quicker recovery but more hospital costs in treatment of incarcerated hernia.The recurrence rate of TAPP is similar to tension-free hernioplasty.

A comparative study on the effects of transabdominal preperitoneal hernia repair and open hernia repair surgery in the treatment of adult inguinal hernia / 中国综合临床

Objective To evaluate the clinical outcomes of different stages of transabdominal preperitoneal hernia repair (TAPP) and open hernia repair surgery (Rutkow) in treating adult inguinal hernia.Methods The clinical data of patients with inguinal hernia undergoing hernia repair(TAPP,TAPP Ⅰ group:56 patients administered TAPP during January 2003 to December 2005 ; TAPP Ⅱ group:76 patients administered TAPP during January to December 2010) and Rutkow hernia-ring filling (Rutkow group:78 patients administered Rutkow during January 2003 and December 2005) were analyzed retrospectively.Clinical indexes and effective indicators were observed to compare the treatment effects of the operation procedures,including duration of surgery,post-operation hospital stay,post-operation leaving bed time,post-operation free activity time,hospitalization costs,time of beginning taking food,and complications.Results The TAPP Ⅱ group had significantly shorter average length of stay,time of beginning taking food,post-operation leaving bed time and post-operation free activity time than the other two groups (average length of stay:(2.6 ± 1.6) d vs.(4.1 ±2.6) d vs.(4.2 ± 1.9) d; time of beginning taking food:(8.6 ± 3.1) h vs.(22.2 ± 3.8) h vs.(20.7 ± 3.2)h;post-operation leaving bed time:(4.6 ±2.2) h vs.(18.3 ±2.3) h vs (20.5 ±3.1) h;Post-operation free activity time:(8.6 ± 2.9) d vs.(15.2 ± 3.3) d vs.(17.1 ± 3.8) d ; P ＜ 0.05).There were no significant differences between TAPP Ⅰ and Rutkow groups on average length of stay,time of beginning taking food,postoperation leaving bed time and post-operation free activity time (P ＞ 0.05).TAPP Ⅰ group had significantly longer duration of operation than the other two groups ((113.3 ± 18.6) min vs.(50.4 ± 11.8) min vs.(48.6 ± 12.1) min,P ＜ 0.05).There was no difference on surgery duration between Rutkow and TAPP Ⅱ groups (P ＞ 0.05).No difference was observed regarding rates of postoperative complications and recurrence (P ＞ 0.05).Conclusion With the advancement of technology,TAPP shows more advantages compared to traditional herniorrhaphy,such as minimal trauma,fewer complications and shorter duration of operation and lower recurrence rate.TAPP is an excellent hernia repair for inguinal hernia.

The placement and fixation of mesh plug and patch in tension-free hernioplasty / 中国医师进修杂志

Objective To explore the method of correctly placing and fixing mesh plug and patch in tension-free hernioplasty. Methods The data of 123 cases of plug-mesh tension-free hernioplasty with the method of placing and fixing mesh plug and patch were reviewed. Observed the incidence of postoperative effusion, infection, sinus formation, skin flap necrosis and hernia recurrence. Results All patients were restored after operation 8 days. Followed-up 1.5 -10.0 years,there was no incision effusion, infection,skin flap necrosis in all cases. No relapse happened on the operated side and 5 cases of inguinal hernia occurred on the non-operated side. Conclusions Mesh plug and patch must be placed to cover the whole abdominal wall defects,and contact closely with surrounding healthy tissue. They need to be placed neatly,fixed firmly and perpetually without any damage to the normal tissue structure.

Patterns of Recurrent Hernias according to the Types of Previous Hernioplasties

PURPOSE: Recently, conventional tissue repairs are gradually being replaced by tension-free hernioplasties using meshes (mesh repairs) in hernia surgery. The aim of the present study was to evaluate patterns of recurrent hernias according to the types of previous hernioplasties. METHODS: From August 2005 to July 2008, 18 hernioplasties were performed in recurrent cases at Chungbuk National University Hospital. All previous hernioplasties were performed at local hospitals except one case of ventral hernia. We reviewed the medical records and compared clinical features according to the types of previous hernioplasties. RESULTS: Among the 18 recurrent hernias, there were 15 inguinal including 2 pediatric cases, an umbilical, and 2 incisional hernias. Among 13 adult inguinal recurrent cases, 5 occurred after tissue repair (3 indirect, 1 direct, and 1 pantaloon type) and 8 after mesh repairs (direct type in all). Recurrence developed earlier after mesh repairs than tissue repairs (median [min~max]; 24 [0.1~164] vs. 243 [60~360] months, P=0.005). Other types of recurrence developed between 6 to 48 months after previous operations. Recurrent hernias after mesh repairs occurred preferentially along the margin of previous meshes. All cases were treated by mesh repairs except in pediatric cases. Median operation time and hospital stay for recurrent inguinal hernias were not different significantly by previous operations. Postoperative complications were minimal without recurrence during a median 5.5-(1.5~25.5)-month follow-up. CONCLUSION: Recurrent hernias develop both after tissue repairs and mesh repairs. After mesh repairs, recurrences develop earlier and are more often associated with technical failure compared to tissue repairs.

Comparison between local anesthesia and epidural anesthesia stratege for tension-free hernioplasty in middle or old aged patients with ingunal hernia / 重庆医科大学学报

Objective:To compare with curative effect,hospital stay,average cost,recovery time and postoperative complication between local anesthesia and epidural anesthesia stratege for tension-free hernioplasty in middle or old-aged patients.Methods:164 cases were randomly divided into local anesthesia and epidural anesthesia groups.Results:Mean operating time,the time of hospital stay and the rate of postoperative complication in local anesthesia groups were less than that in epidural anesthesia groups.Conclusion:Tension-free hernioplasty under local anesthesia,a more safe,effective and cheap operating method in middle or old aged patients with inguinal hernia,should be widespread.

Evaluation of the therapeutic effects of benign prostatic hypertrophy with inguinal hernia in the elderly / 中国医师进修杂志

Objective To evaluate the therapeutic effects and to summarize the clinical experience of benign prostatic hypertrophy(BPH) with inguinal hernia in the elderly 70-89 years. Methods Clinical data of 32 patients 70-89 years old simultaneously undergone transurethral resection of prostate (TURP) and plug-mesh tension-free hernia repair from July 2000 to May 2005 were retrospectively analyzed and followed up. Results The average operating time was (85.0?12.8)minutes, the average blood loss was (90.0? 18.7 )ml. No postoperative death or life threatening complications were revealed. By 7-40 months of following up reported that there were no recurrence of hernia as well as no incontinence and urethral stenosis or other complications. IPSS,maximal flow rate and residual urine were evidently improved after operation. Conclusion Combined TURP and plug-mesh tension-free hernia repair is a safe and effective procedure for the elderly patients.

Comparison between Lichtenstein and Prolene Hernia System (PHS) in Anterior Tension-Free, Inguinal & Femoral Hernioplasty

PURPOSE: The aim of this study was to see if there are any differences in the post-surgical outcomes between 2 tension-free hernioplasty methods. METHODS: We selected those patients with unilateral, bilateral inguinal hernias and femoral hernias who had undergone Lichtenstein n=224) and PHS (n=62) mesh hernioplasty at the Pundang Jaesang Hospital, Department of Surgery, between January 2000 and February 2004, and compared the post-surgical results of each method. The factors analyzed for this comparative study included the patient's age, gender, operation time, length of hospital stay, use of analgesics, cost and recurrences. RESULTS: The results from the statistic showed significant differences between the 2 methods with respect to postoperative pain, cost, duration of hospital stay and recurrences. CONCLUSION: The PHS hernioplasty is a superior method to that of Lichtenstein's herni-oplasty in terms of hospital stay, operation time, postoperative pain & recurrences.

Cause and Treatment of Chronic Pain after Tension-Free Repair of Inguinal Hernia / 中国普外基础与临床杂志

Objective To explore the cause and treatment of chronic pain after tension-free repair of inguinal hernia.MethodsThe clinical data of 426 cases with inguinal hernia underwent the tension-free hernioplasty during February 2002 to September 2007 were retrospectively analyzed.ResultsTension-free hernioplasty was performed to all patients.According to operative methods,they were divided into two groups:polypropylene filling group(n=210)and expanded polytetrafluoroethylene(e-PTFE)mycromesh group(n=216).The chronic pain rate after operation,polypropylene filling group(9.0%,19/210)was significantly higher than e-PTFE mycromesh group(4.2%,9/216),P

Application of Preperitoneal Tension-Free Repair in Inguinal Hernia by Easy Prosthesis D-10 / 中国普外基础与临床杂志

Objective To evaluate the clinical effect of Easy Prosthesis D-10 on open preperitoneal groin tension-free hernioplasty.MethodsThe operative time,operation-correlated complications,hospital stay and recent follow-up findings of 63 patients underwent preperitoneal groin tension-free hernioplasty were analyzed from October 2006 to April 2008.ResultsNo case died in perioperative period.The average operative time was(47.6?10.5)minutes.None of incision infection and scrotal hydrocele occurred.The average hospital stay was(7.7?2.1)days.During follow-up period of 6 to 24 months,no recurrence,chronic pain and foreign body sensation were found.ConclusionThe open preperioneal groin tension-free hernioplasty by Easy Prosthesis D-10 is safe and reliable,especially for the inguinal hernia with large hernia ring or defect of transversalis fascia and recurrent hernia.

A Clinical Comparison of the Mesh Method with the Conventional Herniorrhaphy in Adult Inguinal Hernia

PURPOSE: A tension-free hernioplasty, using mesh prosthetics, has revealed encouraging results in adult inguinal hernia repairs, and is increasingly being performed in Korea. However, there are few reports in Korea analyzing the clinical results of the mesh method. Therefore, this article compares the results of our mesh method with those of the non-mesh method in adult inguinal hernia repairs. METHODS: Between January 2000 and October 2002, 252 herniorrhaphies were performed. With these cases, a retrospective clinical analysis was performed on 52 tension-free herniorrhaphy cases and 48 conventional herniorrhaphy cases. The clinical features analyzed included: age, sex, location, type of operation, operating times, use of postoperative analgesics, length of hospital stays, recurrence rates and complications. RESULTS: The average number of analgesics used was significantly smaller in the mesh than the non-mesh group (P0.05, 4.1 days vs. 4.7 days, respectively). The recurrence rate in the non-mesh method was 6.3% (3/48), but there were no recurrences in the mesh group. Postoperative complications occurred in the non-mesh method group (1 case of a hematoma, and 2 of wound infection), but there were no complications in the mesh group. CONCLUSION: A tension-free herniorrhaphy, with mesh, is a useful technique because it is a pain-relieving operation, with a tendency for lower recurrences and complications than the non-mesh method. Therefore, it is suggest that a tension- free herniorrhaphy, with mesh, may also be a cost effective technique under the Diagnosis Related Group (DRG) system for patients and hospitals.

New Tension-free Hernioplasty Using Umbrella- Shaped Mesh

PURPOSE: Lichtenstein`s tension-free repair & mesh-plug hernia repair are the most frequently used procedures for inguinal hernia repair by american surgeons. A new tension- free hernioplasty procedure, maintaining the advantages of both of these procedures, was invented by an experienced surgeon in our hospital. In this procedure, an umbrella- shaped mesh is applied to the entire posterior wall, not only to the defective area. We analyzed the results of this procedure in comparison with those from conventional repair (Bassini procedure). METHODS: From March 1998 to March 2001, 69 cases of hernioplasty were performed by one staff surgeon. Among these cases, we excluded 2 cases of bilateral inguinal hernia, 1 case of femoral hernia, and 6 cases which were impossible to follow up. In addition, we analyzed 29 cases of tension-free hernioplasty using an umbrella-shaped mesh (U group) and 31 cases of conventional repair (B group). Retrospective chart reviews and telephone interviews were carried out. Operation duration, length of hospital stay, period of analgesics use, complications, time required to return to usual activity, and recurrence were compared between these two groups. RESULTS: No significant differences were found concerning operation duration, period of hospital stay, complications, and time for return to usual activity. The period of analgesic use was significantly shorter in the U group than in the B group (p=0.001, 2.0 days vs 2.9 days). Only one recurrence occurred in B group. CONCLUSION: This new procedure has all the properties of tension free hernioplasty and plug hernia repair. This procedure can be used for all types of inguinal hernia and for a much lower cost than the preformed plug method. No incidence of recurrence was found folling the use of this procedure.

A Clinical Contrast Study on the Tension-free Hernioplasty with Three Operative Methods / 中国医师杂志

Objective To compare the clinical efficacy of tension-free hernioplasty with three operative methods, and analyze the reasons of complications. Methods All Chinese articles dealing with the tension-free hernioplasty included in CNKI from 1997 to 2004 were collected, and divided into three groups according to different operative methods, the clinical efficacy of which was compared. Results The frequecy of foreign matter feel in the Rutknow group was significantly higher than that in the other two groups (P

Lichtenstein's Tension-Free Repair of Groin Hernias: A Single-Surgeon Experience with 321 Cases

PURPOSE: Tension-free hernioplasty has become the most popular procedure for the repair of groin hernias in the United States and United Kingdom. The purpose of this study is to describe a 7-year personal experience with Lichtenstein's tension-free groin hernia repair under local anesthesia. METHODS: We retrospectively studied the clinical outcome of 321 cases of Lichtenstein repairs, performed consecutively by an experienced surgeon between Jan. 1994 and Dec. 2000. RESULTS: Of the 321 cases, 242 (75.4%) were indirect, 34 (10.6%) were direct, 8 (2.5%) were femoral, 7 (2.2%) were pantaloon, and 30 (9.3%) were recurred hernias. The mean age was 55 years; 91% were male. The mean number of injections of analgesics required in the postoperative period was 3.2. The mean hospital stay following repair was 2.7 days. Complications occurred in 23 cases (7.1%). Most of these were minor, consisting of five cases of bruising or hematomas (1.6%), four superficial infections (1.3%), three seromas (0.9%), two hydroceles (0.6%), six patients with persisting groin pain for more than a month (1.8%), one foreign body granuloma, one urinary retention, and one testicular atrophy. There were no recurrences or operative deaths. CONCLUSION: Lichtenstein's tension-free hernioplasty is an easy and simple technique with less pain, minor complications and only rare instances of recurrence. This procedure can be performed on a same-day basis under local anesthesia. Lichtenstein repair may be the most promising technique for the repair of groin hernias.

A Clinical Significance of a Tension-free Hernioplasty with Mesh for Adult Inguinal Hernia Repair

BACKGROUND: Recently, a tension-free herniorrhaphy method using mesh prosthetics has been per formed increasingly in Korea. However, there are few reports discussing the patch-closure method and providing guidance for its use. Therefore, it is necessary to evaluate the clinical significance of using patch-closure method for adult hernia patients. METHODS: From among 239 adult hernia patients a clinical analysis was done retrospectively on 37 patients who had undergone a tension-free herniorrhaphy. The clinicopathologic features analyzed were age, sex, location, symptom, type of operation, anesthetic method, recurrence rate, use of postoperative analgesics, operating time, complications, and length of hospital stay. The clinical features of the tension- free hernioplasty group and a conventional hernioplasty group were compared. RESULTS: The period of analgesics use was significantly shorter in the tension-free hernioplasty group than in the conventional hernioplasty group (p<0.01, 1.5 days vs 2.8 days, respectively). The operative time was significantly longer in the tension-free hernioplasty group than in the conventional hernioplasty group (p<0.01, 105.8 min vs 71.6 min, respectively). The recurrence rate after a conventional hernio plasty was 2.3% (4/117), but there was no recurrence after a tension-free hernioplasty. CONCLUSION: A tension-free hernioplasty with mesh is a pain-relief operation and has tendency for lower recurrence. It is suggested that a tension-free hernioplasty with mesh should be performed for old-aged people and recurrent cases.

Clinical Review of 'Tension Free' Inguinal Hernioplasty with Polypropylene Mesh and Bassini Type Inguinal Hernioplasty

BACKGROUND: All standard methods of hernia repair involve suturing together tissues which are not normally in apposition. This violates the basic surgical principle that tissue must never be approximated under tension and account for an unacceptable number of failures. Total reinforcement of the inguinal floor with a sheet of suitable biomaterial of a 'tension-free' technique is a more effective approach. METHODS: We have treated inguinal hernias by Bassini method in eighty-nine patients and by Lichtenstein tension free method in sixty-one patients from September, 1993 through December, 1995 and compared these two groups on age, sex, site, type anesthesia, operation time, admission date, postoperative complication, postoperative pain-killer injection period, recurrence. RESULTS: The result are as follows 1) There was no significantly difference compared Bassini method with Lichtenstein tension free method on age, sex, site, type, anesthesia, postoperative complications. 2) The average time of operation was 61.8 minutes on Bassini method and 53.6 minutes on Lichtenstein tension free method. 3) The postoperative complications were hematoma 2 cases, wound seroma 1 case on Bassini method, and wound seroma 1 case on Lichtenstein tension free method. 4) The average duration in the hospital stay after operation was 6.01 days on Bassini method and 4.75 days on Lichtenstein tension free method (p<0.01). 5) The average period for injection of pain-killer after operation was 3.61 days on Bassini method and 2.21 days on Lichtenstein tension free method (p<0.01). 6) The recurrence rate was 6 cases(6.7%) on Bassini method and no recurrence case on Lichtenstein tension free method (p<0.05). CONCLUSIONS: We conclude that Lichtenstein tension free method is less painful and shorter postoperative hospital stay than Bassini method.