Recent trends in dealing with inguinal hernial sac

High ligation of the hernial sac is a hallowed and time-honoured concept in inguinal hernia repair and it is considered essential for preventing recurrence. However, this concept has been contested in recent reports. We conducted a prospective study of 186 cases of inguinal hernia repair. In 92 case...

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Bibliographic Details
Published in:Medical journal. Armed Forces India 2003-04, Vol.59 (2), p.108-110
Main Authors: Vincent, PJ, Singh, Y, Joshi, CS, Pujahari, AK, Harjai, MM
Format: Article
Language:English
Subjects:
Hernial sac
Original
Recurrence
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Summary:High ligation of the hernial sac is a hallowed and time-honoured concept in inguinal hernia repair and it is considered essential for preventing recurrence. However, this concept has been contested in recent reports. We conducted a prospective study of 186 cases of inguinal hernia repair. In 92 cases the sac was ligated at the neck and excised, in 94 cases the sac was not ligated at all but either simply inverted or excised without ligation. The type of repair was Bassini's repair, Shouldice repair or Lichtenstein's repair. Degree of post-operative pain was significantly less in those cases where sac was not ligated. There were no cases of recurrence in either group at 3 years follow up. Ligation of sac in inguinal hernia surgery is not only unnecessary and time consuming but also leads to increased post-operation pain. Recurrence is unaffected by not ligating the sac.
ISSN:0377-1237
DOI:10.1016/S0377-1237(03)80050-3