Non-ligation of the hernial sac during repair of indirect inguinal hernia

ABSTRACT

The present study was designed to study the effect of. non-ligation of the hernial sac of indirect inguinal hernia during repair. As ligation of the hernial sac has been considered mandatory for a successful repair and essential for preventing recurrence, the recent studies found that non-ligation of the hernial sac has no effect on recurrence rate and may decrease post operative pain, so we can recommend that it is not necessary to ligate the hernial sac during inguinal hernia repair, as ligation of the hernial sac is a hallowed and time consuming concept and result in increase post operative pain, however, this concept has been contested in recent studies. We conducted a prospective study on sixty patients of indirect inguinal hernia repair. In thirty cases the sac was ligated at the neck and excised [control group] in the other thirty cases the sac was not ligated at all, and either inverted or excised without ligation [test group]. The chosen type of repair was Lichtenstein's repair. Post-operative pain was significantly less in those cases where hernial sac was not ligated as it is recorded by pain score. Also there were no recurrence in either groups at one year follow up. Ligation of the hernial sac during inguinal hernia surgery is not only unnecessary and time consuming but also may increase post-operative pain. And has no effect on recurrence rate