Kannikanti Nageswara RAO, AS GOGATE


Introduction : Lichtenstein tension-free mesh repair (LMR), surgical procedure for inguinal hernia, associated with postoperative pain. The study was aimed to compare self-retaining Freedom ProFlor versus LMR for the reduction of postoperative pain in inguinal hernia.
Methodology : A total of 60 patients with inguinal hernia undergoing mesh repair were randomized into two groups of 30 each: group A (Freedom ProFlor mesh repair) and group B (LMR). Demographic data and clinical findings of all the patients including duration of pain, lump size, cough impulse, and the position of hernia were noted. Recorded findings such as postoperative pain and operative time were subjected to statistical analysis.
Results : Most (31) of the patients had hernia on the right side. The operative time was significantly less in group A when compared to group B (P < 0.05). Significantly lower pain scores were observed in group A than in group B (P < 0.05). The mean post-operative pain was significantly lower in group A compared with group B during the fifth follow-up visit (0.2 ± 0.41 vs. 1.07 ± 1.28; P < 0.0001). 
Conclusion : The Freedom ProFlor mesh repair was better than the LMR regarding postoperative pain. Moreover, the dose of the analgesic needed in Freedom ProFlor mesh repair group was less and for a shorter time when compared to LMR group. However, further long-term studies are required for documenting hernia recurrences.


Full Text:



Osilli D, Awori M, Ojuka D. Factors Influencing Choice of Inguinal Hernia Repair Technique. Ann Afr Surg. 2017;14:3-9.

Schoots IG, van Dijkman B, Butzelaar RM, van Geldere D, Simons MP. Inguinal hernia repair in the Amsterdam region 1994-1996. Hernia. 2001;5:37-40.

Kingsnorth A, LeBlanc KA. Management of abdominal hernias: Springer Science & Business Media; 2013.

Simons M, Aufenacker T, Bay-Nielsen M, Bouillot J, Campanelli G, Conze J, et al. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Springer; 2009.

Chiow AKH, Chong CK, Tan S-M. Inguinal hernias: a current review of an old problem. Proceedings of Singapore Healthcare. 2010;19(3):202-11.

Mabula JB, Chalya PL. Surgical management of inguinal hernias at Bugando Medical Centre in northwestern Tanzania: our experiences in a resource-limited setting. BMC research notes. 2012;5(1):585.

Rao SS, Singh P, Gupta D, Narang R. Clinicoepidemiologic profile of inguinal hernia in rural medical college in central India. J Mahatma Gandhi Inst Med Sci. 2016;21(2):116.

Chan M, Poon C, Chan K, Leong H. Laparoscopic Total Extraperitoneal Versus Open Lichtenstein Inguinal Hernia Repair In Outpatient Setting. Surg Pract. 2009;13(1):A1.

Collaboration EHT. Repair of groin hernia with synthetic mesh: meta-analysis of randomized controlled trials. Ann Surg 2002;235(3):322-32.

Kingsnorth A, Wright D, Porter C, Robertson G. Prolene Hernia System compared with Lichtenstein patch: a randomised double blind study of short-term and medium-term outcomes in primary inguinal hernia repair. Hernia. 2002;6(3):113-9.

de Jonge PvH, Lloyd A, Horsfall L, Tan R, O’Dwyer P. The measurement of chronic pain and health-related quality of life following inguinal hernia repair: a review of the literature. Hernia. 2008;12:561-9.

Amato GI, Agrusa AN, Romano GI. Fixation-free inguinal hernia repair using a dynamic self-retaining implant. Surg Technology Int. 2012;22:107-12.

Amid PK, Shulman AG, Lichtenstein IL. Open" tension-free" repair of inguinal hernias: the Lichtenstein technique. Eur Journal Surg. 1996;162:447-53.

John WM, Ashwin P. Comparison of Lichtenstein and Proflor™ Open Inguinal Hernia Repair in Regards to Immediate Post-Op Pain: A Randomized Double Blinded Registered Clinical Study. J Surg Transplant Sci 2016;4:1040.

de Jonge PV, Lloyd A, Horsfall L, Tan R, O’Dwyer PJ. The measurement of chronic pain and health-related quality of life following inguinal hernia repair: a review of the literature. Hernia. 2008;12:561-9.

Bansal VK, Misra MC, Babu D, Victor J, Kumar S, Sagar R, Rajeshwari S, Krishna A, Rewari V. A prospective, randomized comparison of long-term outcomes: chronic groin pain and quality of life following totally extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) laparoscopic inguinal hernia repair. Surg Endosc. 2013;27:2373-82.

Brescia A, Tomassini F, Berardi G, Pezzatini M, Cosenza UM, Castiglia D, Dall’Oglio A, Salaj A, Gasparrini M. A new fixation-free 3D multilamellar preperitoneal implant for open inguinal hernia repair. Can J Surgery. 2017;60(1):66.

Paliwal CK, Jindel DK, Garg KM. Minimal Dissection: No Fixation Technique For Inguinal Hernia Repair. IOSR Journal of Dental and Medical Sciences. 2016;1(15):34-42.

Bülbüller N, Çetinkaya Z, Kirkil C, Ayten R, Aygen E, Girgin M, et al. Inguinal Hernia Repair via Application of Mesh in Front of and behind the Fascia Transversalis. Ind J Surgery. 2014;76:124-6.



  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution 3.0 License.