SMS Medical College, India
Scientific Tracks Abstracts: J Anesth Clin Res
Aims: Inguinal hernia is among the most common entity encountered in surgical OPD and in the era of
minimal invasive surgery Total Extraperitoneal Repair (TEP) is procedure of choice. In this study we are
comparing extraperitoneal dissection by plain telescopic and balloon dissection in terms of complications
(intraoperative and postoperative including post-op pain and recurrence) and duration of hospital stay.
Methods: 50 cases of inguinal hernia, suitable for laparoscopic procedure, were randomly allocated into two groups, 25 in each, Group-A (Balloon dissection) and Group-B (Plain telescopic dissection) after obtaining written informed consent. Glove finger was used as balloon for dissection in Group-A. Intraoperative, postoperative complications, operative time and hospital stay were documented and patients were followedup for a year for recurrence.
Results: Group-A had 24 males and 1 female with mean age of 55.4 years and Group-B had 23 males and 2 females with mean age of 57.2 years. 55% of inguinal hernia were bilateral. Peritoneal breach was noted in 10 patients in Group-A and 16 patients in Group-B. Two cases were converted in TAPP in Group-B. Postoperative complications like pain, which was measured by Visual Analogue Scale (VAS) at 6 hour post-op had mean value of 2.7 for Group-A and 4.1 for Group-B, Scrotal edema (16% in Group-A and 24% in Group-B) and seroma (12% in Group-A and 56% in Group-B). Mean operative time was 1.68 hours in Group-A and 1.40 hours in Group-B.
Conclusion: After meticulous data analysis we found that balloon dissection has lesser rate of complications both intra and postoperatively, while there was no significant difference in hospital stay. The operative duration was slightly higher in Group-A. Thus we conclude that balloon dissection in TEP is better approach than plain telescopic dissection.
Gaurav Jalendra is a currently a General Surgery Resident at SMS Medical College, Rajasthan, India. He has completed his MBBS from Government Medical College, Kota, Rajasthan. He has published one case report to his credit.