Comparison Of Inguinal Hernia Repair Under Local Anesthesia By Surgical Trainees And Consultants

Abstract

Objective: 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.
Material and Methods: 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.
Results: A total of 298patients 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.
Conclusion: 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