Durganna Thimmappa1, Dayananda Srinivasan2, Sumith S. Deep3
BACKGROUND: Inguinal hernia repairs are commonly performed operations. GPRVS is one of the methods. Also known as Stoppas repair uses large prosthetic mesh placed in preperitoneal plane covering both the hernial orifices i.e., it covers the whole Myopectineal Orifice Bilaterally. Stoppas repair is use full in cases of bilateral hernias, recurrent and multi recurrent hernias, unilateral hernias where risk of recurrence is more i.e., When associated with COPD, BPH, Poor abdominal tone and previous surgery. Purpose of present study is to know the role of Stoppa s repair in management of inguinal hernias especialy Bilateral, recurrent and unilateral hernias which are at the risk of recurrence. METHODS: Study done in victoria hospital attached toBangalore medical college and research centre. 250 cases were included for stoppas repair. Bilateral hernias, recurrent hernias, unilateral hernias with one or more risk factors for recurrence and femoral hernias. Demographic data such as age, gender, occupation, smoking, symptoms as well as comorbid conditions such as chronic obstructive pulmonary disease, prostatism, and recurrence were collected. Duration of surgery was also noted. Complications such as seroma, hematoma, orchitis, and wound infection were recorded. Duration of hospital stay was recorded. Chronic groin pain and recurrences in each group were also recorded. RESULTS: Out of 250 patients 225 had bilateral inguinal hernia and 25 unilateral inguinal hernia, 48 were recurrent and 7 were re recurrent hernia. All the patients were males with age group between 21 to 80 years. All the patients had swelling in the groin region 43.3 % of patients had associated pain. Direct hernia was common variety in this study as mean age in the study was more than 40 yrs. Most of the patients had one or the other risk factor for recurrence smoking was most common 76.6%. Other risk factors are COPD, BPH, Poor abdominal tone, previous surgery and strenuous work. All the patients were subjected to GPRVS under spinal anaesthesia/ epidural anaesthesia with proper size of mesh and duration of surgery was 52 min. Intra operative course was uneventful except 4 cases of peritoneal tear which were sutured without any additional morbidity. Patients were allowed early ambulation. Post-operative course was uneventful without major complications and mortality. 4 cases of Recurrences were seen. Minor complications like seroma were managed conservatively with no sequelae. These results were comparable to other studies.
