Strangulated Groin Hernia Repair: A New Approach for All

The available classical approaches for Groin hernia are multiple. The change of approach with change of incision is needed with these approaches when the bowel is gangrenous.

To evaluate the efficacy and safety of a new approach for all strangulated groin hernias (inguinal, femoral and obturator), in terms of change of approach/complications.

It was conducted in surgical unit-2 of MGM Hospital, Kakatiya Medical College Warangal, Telangana State, India, from Nov 2000 to Oct 2010. Total 52 patients operated with classical approach were compared with 52 patients operated present new approach. All the cases (52+52) were with gangrenous bowel which required resection and end to end anastomosis of bowel. All the cases (52+52) were managed with mesh repair and the results were analysed.

In classical approach: Three cases required laparotomy (5.7%). Twelve cases required change of approach with change of incision (23%). Eight cases developed wound infection after mesh repair (15%). Four cases required removal of mesh (7.6%). Two Cases developed recurrence (3.8%). In present new approach: No laparotomy (0%), no change of incision (0%), no removal of mesh (0%) and no recurrence(0%). Only 2 cases (3.8%) developed wound infection at lateral part of incision ie. p<0.05.

This new approach for all - gives a best approach for strangulated groin hernias as it is easy to follow. It obviates the change of incision and need for a laparotomy. It further retains normal anatomy, prevents contamination of the inguinal canal and permits a mesh repair leading to decreasing the chances of recurrence.