Liehtenstein tension-free repair versus Bassini's repair in inguinal hernia

ABSTRACT

Groin herniorrhaphy is the most common operation performed by the general surgeon. Since the first true herniorrhaphy was performed by Bassini over a century ago, all modifications and surgical techniques have shared a common disadvantage suture line tension. Current studies described that Lichtenstein tension-free repair is simple, less painful, effective, and eschews all suture line tension with low recurrence rate. This study aims at evaluation of Bassini's repair [as an open non-mesh repair] versus Liechtenstein's tension-free repair [with only mesh] for the surgical repair of primary inguinal hernia. The study was carried out on 80 randomly chosen male adult patients with primary groin hernia. These patients were admitted and treated at surgery department. Sohag university hospital and equally divided into two groups of similar number 40 patients in each. Group I Bassini's repair. And group II Lichtenstein repair. Both groups were compared as regard The clinical data, operative data, postoperative data and recurrence rate. All patients were followed up postoperatively for 2 years. 60[75%] had indirect inguinal hernia while 20 cases [25%] were direct inguinal hernias. There is no statistically significant difference as regard operative time between both groups. There was no intraoperative complication in both groups. Postoperative pain was dramatically diminished in the group II than in the group I as reflected by the minimal analgesic requirement. Patients in the Lichtenstein's repair group had returned to normal activities and to work more quickly than in the Bassini's repair group. The Lichtenstein's repair is relatively more expensive than the open approach. Recurrence rate was relatively high in the Bassini's repair group [3] [7.5%] than in the Lichtenstein's repair group [no cases]. Lichtenstein mesh repair is a tension-free hernioplasty, simple and easily performed technique with no disturbance of normal anatomy and the sphincter and shutter mechanisms of the inguinal canal are preserved. It is applicable in all types of primary inguinal hernia with early satisfactory results. Being tension-free, it eliminates all postoperative pain and discomfort, and allows early ambulation of the patients with a low incidence of recurrence when compared with Bassini's repair. It is relatively more expensive