Tension-free groin hernia repair with self-regulating prosthesis (PAD) and its influence on pain.

Kryspin Mitura, PhD. Siedlce Municipal Hospital

The introduction of synthetic materials in hernia surgery allowed accomplishing of the improved results. Modern procedures are based on tension-free technique. This rule has been entirely applied in the innovative hernia repair method – PAD with the use of dynamic self-adapting prosthesis.

The aim of this study was to evaluate the initial results of performed treatment after autoregulating mesh inguinal hernia repair.

PAD hernia repair has been performed in 345 patients with inguinal hernia at the Department of General Surgery between September 2010 and July 2014. The study consisted 328 male patients (95.1%) and 17 female patients (4.9%) aged between 21 and 87 years (average 54.3). Two complementary elements of mesh graft were applied at the surgery. We have analyzed the duration of the surgery and hospitalization, the occurrence of complications during and after the surgery, patients subjective evaluation of the surgery regarding pain and time of returning to normal physical activity, as well as hernia recurrence.

Average duration time of surgery was 51 minutes (ranging from 25 to 115; median 50). The spinal anesthesia was a predominant type of anesthesia (305 patients: 88.4%), in remaining patients a general or local anesthesia has been performed. Mean post-op stay reached 1.8 days (ranging from 1 to 5: median 2). One week after the surgery patients described the pain intensification in ten-points scale VAS (0 – no pain, 10 – maximum pain) An average pain after one week was 3,12 (SD 2,15). VAS ≤3 in 213 patients (61.7%), VAS ≥7 in 18 patients (5,2%). Most of the patients described pain as mild (40.5% patients). At this point 49.1% of patients described the surgery results as very good, 42.6% of patients – as good. The return to full daily activity has been achieved in 2.7 day after the surgery.

Totally tension-free method of PAD inguinal hernia repair provides patients with minimal pain in a postoperative period and allows a prompt return to the daily activity.

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