Comparison of Herniotomy Versus Mesh Repair in Young Patients in terms of Recurrence and Post-Op Complications

Authors

  • Nabeel Haider Department of General Surgery, Pak-Emirates Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
  • Muhammad Shoaib Department of General Surgery, Pak-Emirates Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
  • Muzammil Hussain Department of General Surgery, Pak-Emirates Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
  • Abdullah Bin Masood Department of General Surgery, Pak-Emirates Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
  • Tayyab Awais Ali Department of General Surgery, Pak-Emirates Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
  • Waleed Umer Department of General Surgery, Pak-Emirates Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76i6.13291

Keywords:

Hernia, Herniotomy, Inguinal, Mesh

Abstract

Objective: To compare the outcomes associated with herniotomy and mesh repair in young patients for treating inguinal hernia (IH).

Study Design: Prospective comparative study.

Place and duration of study: General Surgery Department of Pak-Emirates Military Hospital Rawalpindi, Pakistan, from Jul 2024 to Feb 2025.

Methodology: One hundred(n=100) patients underwent surgical treatment for IH and were segregated into two groups. Group-A had a mesh repair, and Group-B had herniotomy without mesh placement. Patients underwent surveillance after the procedure, and results were established.

Results: One hundred patients were recruited, and equally segregated into two groups. The operation time was 40.50 minutes (median) for herniotomy and 50.00 minutes (median) for mesh repair (p<0.001). After herniotomy, 1(2%) patient developed seroma, and after mesh repair 2(4%) patients developed seroma (p-value 0.55). Hematoma was formed in 2(4%) patients after herniotomy and in 1(2%) patient after mesh repair (p-value 0.55). One (2%) patient had wound infection after herniotomy, and 3(6%) patients had wound infection after mesh repair (p=0.30). Chronic groin pain (CGP) was present in 4(8%) patients after mesh repair and 2(4%) patients after herniotomy (p-value 0.40). Recurrence was observed in 2(4%) patients after herniotomy and in no patient after mesh repair (p=0.15).

Conclusion: In young patients, herniotomy is an acceptable alternative compared to mesh repair, with no difference in terms of recurrence and complications.

Downloads

Download data is not yet available.

References

1. Hammoud M, Gerken J. Inguinal hernia (Updated 2023 Aug 8). In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024. [cited 25th March 2025] Available from:

https://www.ncbi.nlm.nih.gov/books/NBK513332/

2. Rosenberg J, Baig S, Chen DC, Derikx J. Groin hernia. Nat Rev Dis Prim 2025; 11(1): 47.

https://doi.org/10.1038/s41572-025-00631-4

3. O'Brien J, Sinha S. Inguinal hernia repair: a global perspective. ANZ J Surg 2021; 91(11): 2288–2295.

https://doi.org/https://doi.org/10.1111/ans.17174

4. Cowan B, Kvale M, Yin J, Patel S, Jorgenson E, Mostaedi R, et al. Risk factors for inguinal hernia repair among US adults. Hernia 2023; 27(6): 1507-1514.

https://doi.org/10.1007/s10029-023-02913-w

5. Tigora A, Radu PA, Garofil DN, Bratucu MN, Zurzu M, Paic V, et al. Modern perspectives on inguinal hernia repair: a narrative review on surgical techniques, mesh selection and fixation strategies. J Clin Med 2025; 14(14): 4875.

https://doi.org/10.3390/jcm14144875

6. Reistrup H, Fonnes S, Rosenberg J. No Reason to Use Mesh in Groin Hernia Repair in Adolescents. J Abdom Wall Surg 2024; 2: 12336. https://doi.org/10.3389/jaws.2023.12336

7. Attaar M, Forester B, Chirayil S, Su B, Wong HJ, Kuchta K, et al. Mesh in Elective Hernia Repair: 10-Year Experience with over 6,000 Patients. J Am Coll Surg 2021; 233(1): 51-62.

https://doi.org/10.1016/j.jamcollsurg.2021.03.006

8. Smith SM, Khoja AA, Jacobsen JHW, Kovoor JG, Tivey DR, Babidge WJ, et al. Mesh versus non-mesh repair of groin hernias: a rapid review. ANZ J Surg 2022; 92(10): 2492-2499.

https://doi.org/10.1111/ans.17721

9. Reistrup H, Andresen K, Rosenberg J. Low incidence of recurrence and chronic pain after groin hernia repair in adolescents: a systematic review and meta-analysis. Langenbecks Arch Surg 2023; 408(1): 211.

https://doi.org/10.1007/s00423-023-02947-9

10. Kim SH, Jung HS, Park S, Cho SS. Inguinal hernia repair with or without mesh in late adolescent males. Ann Surg Treat Res 2021; 100(4): 246-251. https://doi.org/10.4174/astr.2021.100.4.246

11. van Veen RN, Wijsmuller AR, Vrijland WW, Hop WC, Lange JF, Jeekel J, et al. Long-term follow-up of a randomized clinical trial of non-mesh versus mesh repair of primary inguinal hernia Br J Surg 2007; 94(4): 506-510. https://doi.org/10.1002/bjs.5627

12. Campanelli G, Bertocchi V, Cavalli M, Bombini G, Biondi A, Tentorio T. et al. Surgical treatment of chronic pain after inguinal hernia repair. Hernia 2013; 17(3): 347-353.

https://doi.org/10.1007/s10029-013-1059-x

13. Sæter AH, Fonnes S, Rosenberg J, Andresen K. Mesh versus non-mesh for emergency groin hernia repair. Cochrane Database Syst Rev 2022; 2022(6).

https://doi.org/10.1002/14651858.CD015160

14. Watanobe I, Miyano S, Machida M. Mesh shrinkage after transabdominal preperitoneal inguinal hernia repair. Sci Rep 2023; 13: 3894. https://doi.org/10.1038/s41598-023-31088-8

15. Lobe TE, Bianco FM. Adolescent inguinal hernia repair: a review of the literature and recommendations for selective management. Hernia 2022; 26(3): 831-837.https://doi.org/10.1007/s10029-021-02551-0

16. Tiwary SK, Kumar S, More R, Shankar V, Kumar S, Dwivedi AND. A study of contralateral occult inguinal hernia in adult male patients undergoing total extraperitoneal herniorraphy. J Family Med Prim Care 2020; 9(6): 2975-2979.

https://doi.org/10.4103/jfmpc.jfmpc_207_20

17. Criss CN, Gish N, Gish J, Carr B, McLeod JS, Church JT, et al. Outcomes of Adolescent and Young Adults Receiving High Ligation and Mesh Repairs: A 16-Year Experience. J Laparoendosc Adv Surg Tech A 2018; 28(2): 223-228.

https://doi.org/10.1089/lap.2017.0511

18. Van Kerckhoven G, Toonen L, Draaisma WA, de Vries LS, Verheijen PM. Herniotomy in young adults as an alternative to mesh repair: a retrospective cohort study. Hernia 2016; 20(5): 675-679. https://doi.org/10.1007/s10029-016-1529-z

19. Taylor MA, Cutshall ZA, Eldredge RS, Kastenberg ZJ, Russell KW. High ligation in adolescents: is it enough? J Pediatr Surg 2021; 56(10): 1865-1869.https://doi.org/10.1016/j.jpedsurg.2020.11.006

20. Melkemichel M, Bringman S, Nilsson H, Widhe B. Patient-reported chronic pain after open inguinal hernia repair with lightweight or heavyweight mesh: a prospective, patient-reported outcomes study. Br J Surg 2020; 107(12): 1659-1666.

https://doi.org/10.1002/bjs.11755

21. Bay-Nielsen M, Nilsson E, Nordin P, Kehlet H. Chronic pain after open mesh and sutured repair of indirect inguinal hernia in young males. Br J Surg 2004; 91(10): 1372-1376.

Downloads

Published

30-10-2026

Issue

Section

Original Articles

Categories

How to Cite

1.
Haider N, Muhammad Shoaib, Muzammil Hussain, Abdullah Bin Masood, Tayyab Awais Ali, Waleed Umer. Comparison of Herniotomy Versus Mesh Repair in Young Patients in terms of Recurrence and Post-Op Complications. Pak Armed Forces Med J [Internet]. 2026 Oct. 30 [cited 2026 Oct. 30];76(6):842-5. Available from: https://www.pafmj.org/PAFMJ/article/view/13291