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Inguinal mesh hernioplasty under local anaesthesia.

OBJECTIVE
To determine the frequency of operative and post-operative complications of Mesh hernioplasty for inguinal hernia under local anaesthesia and assess its safety.


METHODS
This prospective study was conducted at Surgical Unit II, Liaquat University Hospital, Jamshoro, from January 2008 to October 2009. Only male patients between 20-65 years, having reducible direct or indirect complete or incomplete inguinal hernia were included. In the operation theatre local anaesthesia was infiltrated at the site of the hernia. The recommended open procedure was followed with the application of polypropylene mesh. The patients were shifted to the wards where they were put under observation for pain, vomiting, hypotension, urinary retention and wound haematoma, hourly for six hours and then onward till discharged from hospital.


RESULTS
During the study, 108 male patients were included. Mean age was 38.5 +/- 10.12 years, 81 (75%) patients had indirect inguinal hernia; 27(25%) had the direct variety. In our study, 23 (21.25%) patients had minor problems during the procedure. Post-operatively, 31 (28.70%) patients developed wound pain, and of these 17 (54.83%) were in the early phase and 14 (45.16%) were in the late phase. Haematoma was seen in 4 (3.70%) patients, and of them, 1 (25.0%) developed this complication in the early phase, whereas 3 (75.0%) in the late phase. Two patients (1.85) in early post-operative phase had vomiting and one (0.92%) patient had urinary retention, while 3 (2.7%) patients in late phase had wound infection. The post-operative hospital stay ranged from 6 to 52 hours. The mean hospital stay was 27.27 +/- 9.91 hours.


CONCLUSION
Inguinal hernia repair under local anaesthesia is safe and convenient. It has benefits like reduced risk of cardiopulmonary complications, short hospital stay and early return to routine life.