Modified bassini versus lichtenstein technique of inguinal hernia repair in Mulago Hospital Kampala

Abstract

Inguinal hernia repair has been evolving for the past 130 years since the pioneering work of Bassini. In the quest for the ideal repair technique, prosthetic repair has now surpassed the Bassini as the standard method for inguinal hernia repair in many hernia clinics. However, the problem remains- our constant search for one operation that can be used for all groin hernias, regardless of type, size or body habitus. A prospective randomized study to compare the short-term outcome of the modified Bassini and the tension-free Lichtenstein mesh repair techniques in adult patients with primary unilateral inguinal hernia was carried out in Mulago Hospital between October 2001 and February 2002. Eighty-eight patients were recruited into the study. There were 74 (84%) men and 14(16%) women with a mean age at presentation of 41.8 years (range 18-88 years). The patients were operated on a day-case basis. The anaesthetic technique of choice was local anaesthetic infiltration and none of the patients required general anaesthesia. Patients were followed up postoperatively for fourteen days. Three patients were lost to follow-up. The tension-free Lichtenstein repair took significantly longer than the modified Bassini repair (mean 14.5 versus 12.3; p<0.001). There were no major complications related to the operations. Statistical significance was observed in the development of seromas in the tension-free Lichtenstein repair group (p=0.026). The difference in days taken to resume normal gait approached statistical significance in favor of the tension-free Lichtenstein repair (p=0.065). There was no statistical difference in the development of other complications and in the pain scores. This study showed no major difference in the short-term outcome between the modified Bassini and the Lichtenstein technique of inguinal hernia repair.