Comparison of inguinal hernia repair under local anesthesia by surgical trainees and consultants

ABSTRACT

To evaluate the outcome of Lichtenstein repair under local anesthesia in term of safety, efficacy and complications and to compare the results of surgical trainees with their consultants. All Consecutive patients with primary inguinal hernia undergoing Lichtenstein repair under local anesthesia by our trainees and consultants over a 05 year period were included into the study. Operative time, hospital stay and complications were assessed. Data was analyzed using SPSS version 17. A total of 298 patients were included in the study; 15 patients were excluded from the study due to loss of follow up. Data analysis has been done for 283 patients. All the study subjects were male with a mean age of 39.28 +/- 12.61 years. Indirect inguinal hernia [91%] was the commonest, followed by direct inguinal hernia [6.7%] and sliding hernia was only in 1.6% of the patients. Majority of the hernia repairs 221[78%] were performed by the residents and only 62[21.9%] were performed by the consultants. The operative time was slightly more for residents 46.8 versus 42.8 minutes [P<0.05]; whereas hospital stay was comparable between the two groups1.23 versus 1.27 days [P=0.562]. Minor postoperative complications occurred in 24[8.5%] patients. Wound infection, scrotal hematoma and chronic pain were the most common complications in 1.4% patients. All these complications were managed conservatively including wound infection. However recurrence occurred in 2[0.7%] patients of residents group. Inguinal hernia can be safely repaired under local anesthesia and it is one of the procedures that can be safely delegated to surgical trainees with comparable results with consultants