Intraoperative Inguinal Measurements to Estimate a Single Optimal Mesh Size for Lichtenstein Inguinal Hernioplasty: an Observational Study

In inguinal hernia surgery, use of optimal mesh size during Lichtenstein hernioplasty technique is essential in preventing recurrence. This study was an attempt to determine a single optimal mesh size which can be adapted in vast majority of cases based on intraoperative inguinal measurements. This observational study was done for 1 year in the Department of Surgery, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi, India. A total of 60 patients aged above 18 years who were scheduled for elective inguinal hernioplasty using the Lichtenstein technique for direct or indirect inguinal hernia were subjected to intraoperative measurements. All the patients were male with mean age of 52.75 ± 15.39 years. Mean body mass index (BMI) was 24.51 ± 3.10 kg/m². With regard to hernia characteristics, most of the patients had right-sided hernia (61.7%), indirect (51.67%), and incomplete hernia (81.67%). The mean width of mesh required was 6.65 ± 0.24 cm and mean length was 13.75 ± 0.25 cm. The mesh size was comparable with respect to demographic characteristics, anthropometry, BMI, and type and extent of hernia (p > 0.050) but age and length of mesh size varied significantly in patients with direct and indirect type of hernia (p < 0.050). The present study made an attempt to determine a single optimal mesh size in cases who underwent inguinal hernia repair based on the principles of Lichtenstein hernioplasty, which being 6.7 cm × 13.8 cm. Another significant finding was varying in mesh length size between direct and indirect hernias.