Comparison between Single Mesh and Double Mesh Placement in Huge Inguinal Hernia

Document Type : Original Article

Authors

1 Department of Surgery, Ministry of Health, Egypt

2 Department of General Surgery, Damietta Faculty of Medicine, Al-Azhar University, Egypt

Abstract

Background: Recurrence after surgical treatment of inguinal hernia is still a challenge facing surgeons during their daily practice.
Aim of the Work: The current trial aims to compare single and double mesh placement in huge inguinal hernia repair.
Patients and Methods: 40 cases were involved in the study. They were classified into two equal groups according to the operative technique [A for single mesh and B for double mesh]. The study's candidates were examined and investigated thoroughly regarding their complaint, the presence of a clinically detectable hernia in the inguinal region, its size, characters, onset, duration, and associated symptoms. Then, all were examined clinically and prepared for surgical intervention after lab investigations.
Results: The mean ages were 56 and 56.9 years for groups A and B. Both groups were comparable to body mass index, risk factors, type of hernia, hernia side, and intraoperative blood loss. There was a significant decrease in operative time in group A when compared to group B [54.50 ± 8.256 vs. 61.25 ± 6.664 minutes, respectively]. The overall rate of complications was lower in group B when compared to group A [30.0% vs. 50.0%, respectively]. Complications in group A were seroma [10.0%], wound infection [5.0%], scrotal edema [25.0%], and chronic pain [10.0%]; while in group B, seroma [10.0%], scrotal edema [5.0%], chronic pain [15.0%]. Recurrence was confined to group A, and reported to three patients [15.0%]. However, the difference was statistically nonsignificant.
Conclusion: Double mesh technique is a safe and efficacious approach for managing huge inguinal hernia. It is associated with lower rate of recurrence than the single mesh approach with comparable operative time, complications, and outcomes. 

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