Open Preperitoneal (Posterior Approach) vs Darning Repair (Anterior Approach) for Inguinal Herniorraphy

Abstract

Background: It is a single blind controlled prospective comparative study in which Open preperitoneal
herniorraphy (OPH) is compared with conventional anterior approach i.e. Darning repair, regarding early
complications (like pain, swelling, infection etc)and recurrence rate.
Patients & Methods: The study was conducted in Surgical Unit-I Services Hospital Lahore over the
period of 3 years from Jan 2002 to Dec 2004.A total of 80 patients of Inguinal Hernia were selected
randomly for OPH and Darning repair. Only males over the age of 12years without any co-morbid disease,
admitted through OPD were selected for study. The patients were operated on elective list under General or
Spinal Anesthesia. Postoperatively patients were kept in ward for at least 24 hrs and they were routinely
followed up for 2 years on out-door basis after discharge
Results: Mean operation time for OPH 30mins (20-60mins) was shorter than Darning repair
45mins (30-80mins).Most patients had mild pain after OPH (60%) as compared to Darning repair
(40%).The median time to return to work after OPH (2weeks) was less than after Darning repair
(4weeks).But the incidence of subcutaneous haematoma formation (5%) was same after both
types of repairs and there was no recurrence (0%) seen after 2years, on follow-up
Conclusion: In conclusion Open-preperitoneal herniorraphy is better than conventional Anterior
approach in terms of less operative time, post-op pain, early return to work, although there was no
recurrence seen after both types of repairs.