Inguinal Hernia
Conditions
Keywords
Inguinal Hernia, Hernia Repair, Guarnieri Technique, Desarda Technique, Lichtenstein Hernioplasty
Brief summary
The aim of this study is to compare the surgical outcome of both Lichnichtien tension free mesh hernioplasty of inguinal hernia and the combined modified Guarnieri Desarda technique in terms of postoperative pain, post operative complications (seroma, hematoma, wound infection), chronic inguinodenia, early recurrence and assessment of testicular vascularity and size by application of a testicular duplex and ultrasound.
Interventions
PROCEDURELichtenstein Mesh-Based Hernioplasty
This is a tension-free hernioplasty procedure that uses a synthetic mesh to reinforce the inguinal canal floor. The mesh is fixed to the inguinal ligament and internal oblique aponeurosis, creating a barrier to prevent hernia recurrence. It is considered the gold standard for inguinal hernia repair and is widely used for its effectiveness in reducing recurrence rates and postoperative complications.
PROCEDURECombined Modified Guarnieri-Desarda Tissue-Based Hernioplasty
This technique combines elements of the Guarnieri and Desarda tissue-based repairs. It does not involve the use of synthetic mesh, relying instead on the patient's own tissues to reinforce the inguinal canal. The Guarnieri technique reshapes the internal ring to improve the inguinal canal's shutter mechanism, while the Desarda technique reinforces the posterior wall using the external oblique aponeurosis. This approach aims to preserve natural anatomy and minimize complications associated with mesh use.
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
This study follows a parallel assignment model. Patients are randomly assigned to one of two groups: the Lichtenstein mesh-based repair group (L group) or the combined modified Guarnieri-Desarda tissue-based repair group (C group). The interventions are performed independently in each group, with outcomes compared between the two. There is no blinding in this study, and both the participants and the surgeons know which procedure is being performed (open-label study). The primary focus is on comparing the effectiveness and safety of the two surgical techniques.
Eligibility
Sex/Gender
MALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult male patients aged 18 years or older. * Patients diagnosed with non-complicated inguinal hernia (both direct and indirect). * Patients able to provide written informed consent to participate in the study.
Exclusion criteria
* Patients younger than 18 years old. * Patients with complicated hernias (e.g., inflamed, obstructed, or strangulated hernias). * Patients with a recurrent inguinal hernia. * Patients with weak or thin external oblique aponeurosis (intraoperative findings). * Patients with a history of prior surgery in the inguinal region. * Patients who refuse to participate in the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Pain Assessment | At 2 weeks, 1 month, 3 months, and 6 months post-surgery. | Postoperative pain will be evaluated using the Mankoski Pain Scale (0-10). Pain scores will be recorded at different time intervals to assess immediate and long-term postoperative pain, with scores from 0 to 2 considered negligible, and scores from 3 to 10 considered significant. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of Postoperative Complications | At 2 weeks, 1 month, and 3 months post-surgery. | The occurrence of postoperative complications such as seroma, hematoma, wound infection, and testicular complications (e.g., hydrocele, cord induration) will be recorded and analyzed for each group. |
| Hernia Recurrence Rate | At 6 months and 1 year post-surgery. | The rate of hernia recurrence will be assessed through clinical examination and imaging, comparing recurrence between the Lichtenstein mesh-based repair group and the modified Guarnieri-Desarda tissue-based repair group. |
| Testicular Vascularity | At 3 months post-surgery. | Testicular vascularity will be evaluated using testicular duplex and ultrasound, comparing any changes pre- and post-surgery between the two groups. |
Countries
Egypt
Contacts
Primary ContactFadi F. Khalil, MSc
Outcome results
None listed