Inguinal hernia day case surgery: study of 100 cases

ABSTRACT

This Prospective study was carried out at Surgical Department of Jinnah Hospital Lahore from January 1998 to September 1999, to evaluate the merits and demerits of day case surgery of inguinal hernia in our set up. One hundred patients of simple reducible inguinal hernia presenting in surgical out patient department were included in this study. Patients were selected after discussion with the anaesthatist. Only class I or II patients as mentioned by American society of anaesthesiologists were included. Instructions about preoperative prepration and time to come for surgery were given on non resident basis. All patients were operated under general anaesthesia early on the list. Surgical procedures performed were herniotomy in 27 patients [27%] in children and young fit adults with good inguinal musculature. Herniorrhaphy [darning] was performed in 73 patients [73%] having direct inguinal hernia or indirect inguinal hernia and week posterior wall of the inguinal canal. Main post operative stay in the hospital was eight hours. Four patients [4%] developed scrotal oedema and two patients [2%] developed scrotal haematoma relieved by scrotal support. Two patients [2%] developed superficial [subcutaneous] wound infection which was cured by drainage and dressing on outdoor basis. Five patients [5%] developed postoperative neuralgia at the site of wound which was relieved simply by use of analgesics, except in one case in which local steroid injection was given at the site of maximum tenderness. There was no single recurrence reported in one year follow up after surgery Day case surgery for inguinal hernia can be performed safely in carefully selected patients with no anaesthetic complications and minimal morbidity. The economic benefits are enhanced by short stay, low morbidity and early return to normal activities