Herniography: a prospective, randomized study between midline and left iliac fossa puncture techniques

To determine whether an optimal site of injection exists for herniography.

This was a prospective, randomized study of 93 consecutive patients who were referred for herniography over a period of 9 months. Patients underwent either a left iliac fossa (LIF) or midline puncture. Parameters assessed included initial adequate needle placement, complications, pain scores and body mass index (BMI). The groups were compared using Chi-squared test for categorical data, Student's t-test for continuous data and the Mann-WhitneyU-test for skewed data, withP < 0.05 considered statistically significant

Four complications were encountered (4%), and these were equally distributed between the two groups. Adequate initial positioning of the needle was similar in both groups. The volume of local anaesthetic used was correlated with discomfort using a pain scale: a volume of >6 ml resulted in significantly more pain. More frequent initial adequate needle placement was observed in thin patients (BMI < 45 kg/m(2)) with experienced operators. Conversely, increased body mass index resulted in more difficult needle placement.

Herniography is a safe procedure with few complications. There was no significant difference comparing the midline and LIF approaches.Nadkarni, S.et al. (2001). Clinical Radiology56, 389-392.