Inguinal hernia: tension-free procedures

OBJECTIVE: Tension-free procedures are aimed to minimize post-operative pai n and rate of recurrence, by replacing sutures under tension by a mesh with out any approximation of the margins of the hernial orifice. Moreover they offer the advantage of being performed under local or epidural anesthesia. The aim of this study was to verify by a prospective multicentre evaluation , if the results attributed to these procedures are obtained in current pra ctice. RESULTS: Evaluation involved 435 hernias, treated by Lichtenstein procedure , Gilbert plug and Perfix(R) plug. There were 19 postoperative benign compl ications (4.4%). The durations of analgesics consumption, post-operative ho spital stay, cessation of normal activities and time off work [mean, [(SD), (extremes)]] were 3.3 days [(3.9) (0-60)], 1.3 days [(1.1) (0-16)], 4.5 da ys [(3.1) (0-34)] and 15.4 days [(10.2) (0.60)] respectively With a mean fo llow-up of 36 months [(14) (6-67)], 423 hernias (97.2%) were assessed. Two (0.5%) recurrences occurred. Twenty three patients had secondary troubles ( 5.8%). 21 patients complained of chronic pain, one had atrophy of the testi s and one plug had to be removed. CONCLUSION: Our results confirm that tension-free procedures are minimally invasive, induce lew benign postoperative complications, low pain and allow early return to normal activity.