CC BY-NC-ND 4.0 · Avicenna J Med 2015; 05(04): 106-109
DOI: 10.4103/2231-0770.166891
ORIGINAL ARTICLE

Three stitch hernioplasty: A novel technique for beginners

Manikandan Patchayappan
Department of General Surgery, Thanjavur Medical College and Hospital, Thanjavur, Tamil Nadu, India
,
Sangara Narayanan Narayanasamy
Department of General Surgery, Stanley Medical College and Hospital, Chennai, Tamil Nadu, India
,
Nagarajan Duraisamy
Department of General Surgery, Thanjavur Medical College and Hospital, Thanjavur, Tamil Nadu, India
› Author Affiliations
Financial support and sponsorship Nil.

Abstract

Objective: To analyze mesh fixation with minimum sutures and postoperative complications. Study Design: Prospective study. Place and Duration of Study: Department of General Surgery, Thanjavur Medical College and Hospital, Tamil Nadu, from July 2010 to June 2012. Materials and Methods: All inguinal hernia patients, who fulfilled the sample selection criteria, were admitted and planned for surgery. The prolene mesh is fashioned as in Lichtenstein's repair, placed and fixed only by three prolene stitches. The first stitch is made in the periosteum of pubic tubercle. The second stitch is taken in the inguinal ligament (1.5 cm lateral to the pubic tubercle) and the third stitch is from the medial most part of the conjoint tendon, that is, the mesh is fixed in the medial aspect alone. Results: Majority of the patients fall between the age group of 40 and 60 (72%) years and all are male patients. Of the total cases, 50% were right sided, 25% were left sided, and 25% were bilateral. Of the postoperative complications, 12% had seroma, 4% had hematoma, 2% developed surgical site infection, 2% developed chronic groin pain, 1% presented with recurrence, and none developed foreign body sinus. Conclusion: The incidence of long-term complications of three stitch hernioplasty are comparable to that of the other standard, tension-free open hernia repair as well as other laparoscopic procedures. Moreover, the three stitch hernioplasty method is a simple method, easy for the beginners to adopt, has less foreign body reaction, less time consuming, causes less tissue trauma, and lesser chance for vascular injury.



Publication History

Article published online:
09 August 2021

© 2015. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 
  • References

  • 1 Millikan KW. Incisional hernia repair. Surg Clin North Am 2003;83:1223-34.
  • 2 Burger JW, Luijendijk RW, Hop WC, Halm JA, Verdaasdonk EG, Jeekel J. Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 2004;240:578-83.
  • 3 Arroyo A, García P, Pérez F, Andreu J, Candela F, Calpena R. Randomized clinical trial comparing suture and mesh repair of umbilical hernia in adults. Br J Surg 2001;88:1321-3.
  • 4 Conze J, Kingsnorth AN, Flament JB, Simmermacher R, Arlt G, Langer C, et al. Randomized clinical trial comparing lightweight composite mesh with polyester or polypropylene mesh for incisional hernia repair. Br J Surg 2005;92:1488-93.
  • 5 Martín-Duce A, Noguerales F, Villeta R, Hernández P, Lozano O, Keller J, et al. Modifications to Rives technique for midline incisional hernia repair. Hernia 2001;5:70-2.
  • 6 LeBlanc KA. Laparoscopic incisional and ventral hernia repair: Complications-how to avoid and handle. Hernia 2004;8:323-31.
  • 7 Morales-Conde S, Cadet H, Cano A, Bustos M, Martín J, Morales-Mendez S. Laparoscopic ventral hernia repair without sutures – Double crown technique: Our experience after 140 cases with a mean follow-up of 40 months. Int Surg 2005;90 3 Suppl: S56-62.
  • 8 Abbonante F, Witkowski P. Early results of tension free sutureless ventral hernia repair. Orlando, FL: American Hernia Society Congress; 2004.
  • 9 Lomanto D, Iyer SG, Shabbir A, Cheah WK. Laparoscopic versus open ventral hernia mesh repair: A prospective study. Surg Endosc 2006;20:1030-5.
  • 10 Eklund AS, Montgomery AK, Rasmussen IC, Sandbue RP, Bergkvist LA, Rudberg CR. Low recurrence rate after laparoscopic (TEP) and open (Lichtenstein) inguinal hernia repair: A randomized, multicenter trial with 5-year follow-up. Ann Surg 2009;249:33-8.
  • 11 Jaiswal SS, Chaudhry R, Agarwal A. Chronic groin pain following Lichtenstein mesh hernioplasty for inguinal hernia. Is it a myth? Indian J Surg 2009;71:84-8.