A Prospective Comparative Study of Invagination of Indirect Inguinal Hernial Sac with Excision of Indirect Inguinal Hernial Sac

Background: Lichtenstein tensionfree meshplasty is the preffered method of hernia repair by majority of surgeons. Recently it is believed that ligature and excision of richly innervated and vascularised peritoneal sac leads to postoperative pain and discomfort due to miniature peritonitis. Aim of this study is to compare postoperative pain, complications and recurrence in both groups of patients. Methods: This study is single centred, prospective, comparative, randomized study, carried out in PDU Medical college and hospital, Rajkot between June 2018 to june 2020. A total 50 patients were enrolled which were randomized in two groups, A- excision of sac, B- invagination of sac. All Patient with indirect inguinal hernia were included and congenital hernia, complicated hernia, complete indirect hernia excluded. All the cases were followed up for 6 months. Visual Analogue Scale (VAS) used to assess postoperative pain. Results: Most common Age was between 21-30 yrs. Mean postoperative pain in group A was 4.53+0.28, group B was 3.72+0.54 with p value less than0.001. Postoperative pain on 6th hour, 24th hour, Post-operative day 1, 3, 7, 15 was recorded which was found less in group B i.e. Invagination of sac. Post-operative complications like Seroma, Scrotal edema, Urinary retension, Hematoma was comparable though the difference was not statistically significant, No seroma, induration and Recurrence found in both groups on follow up on 1 month, 3 month, 6 month. Chronic groin pain in 3 patients in group A and 1 patient in group B was found. Conclusion: Invagination of sac results in less postoperative pain compared with excision with no significant difference is found in postoperative complications and recurrence in both surgical techniques.