A Prospective Randomized Controlled Study of Lichtenstein's Tension Free versus Modified Bassini Repair in the Management of Groin Hernias

Background: Bassini's repair and the Lichtenstein's tension free mesh hernioplasty are commonly used hernia repair techniques. A prospective randomized controlled study of Lichtenstein's tension free versus modified Bassini repair in the management of groin hernias was undertaken to compare the technique and postoperative course in the two procedures.

Methods: A prospective study was conducted on patients reporting to Command Hospital (SC) Pune with inguinal hernia. One hundred and ninety six patients were included in the study, operated upon by either of technique and followed up.

Results: Study involved 196 patients with 216 primary inguinal hernias, studied over a period of 24 months. A total of 118 Bassini repair and 98 Lichtenstein's repair were done. Of the 196 patients, four were females. Bassini Repair took more time than Lichtenstein's repair, though the difference was not statistically significant (p>0.05). Direct hernias took lesser time to operate than the indirect hernias. Pain on the operative day, in the evening, was similar in both the groups. The commonest complication in both the groups was scar tenderness followed by erythema, scrotal swelling, neuralgia, superficial wound infection, funiculitis and seroma formation in the order of frequency. The average hospital stay was 5.74 days for Bassini's repair as compared to 4.97 days for Lichtenstein's repair. Patients undergoing Bassini's repair took longer (mean 28.4 days) to return to work as compared to those who underwent Lichtenstein's repair (mean 21.4 days) and the difference was statistically significant (p < 0.05). The recurrence rate was similar in Bassini's (6.78%) and Lichtenstein's repair (5.10%).

Conclusion: The Lichtenstein's tension free mesh hernioplasty was comparatively better than modified Bassini's repair due to its simplicity, less dissection and early ambulation in the postoperative period. Surgeons in training found the technique easier to master than the Bassini's repair.