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ORIGINAL ARTICLE
Year : 2015  |  Volume : 3  |  Issue : 1  |  Page : 7-11

A comparative study on outcome of Lichtenstein's hernioplasty done by residents and by the consultant surgeon


Department of General Surgery, IPGMER and SSKM Hospital, Kolkata, West Bengal, India

Correspondence Address:
Bappaditya Har
82/6 Goutamnagar, New Delhi - 110 049
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2320-3846.153800

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Introduction: Surgeon's case volume,hospital volume and specialisation improve the outcome of many major surgical procedures gastrectomy, esophagectomy and rectal surgery. The exact role of specialist centers in more common surgical operations like inguinal hernioplasties and varicose vein, is still not so clear. Hernioplasty done by a resident may allow consultant to concentrate on major critical cases. In this study we analysed whether well-trained surgical residents are able to perform Lichtenstein operation with an acceptable immediate and long-term outcome compared to the experienced specialist consultants in hernia surgery. Materials and Methods: Patients were subjected randomly to lichenstein mesh hernioplasty by well trained residents (after assisting 10 operation with consultant) and consultants. Parameters were noted during operation and in follow up accordingly. Hernioplasty done by experienced consultant surgeon (n=51) and by residents (n=53). Results: The mean operating time taken by the residents (66 ± 10 minutes) was significantly higher than that of the consultant surgeons (49 ± 10 minutes). The post-operative infection rates in the current study for surgeries done by residents and consultants were 7.7% and 3.9%, respectively. The occurrence of post-operative wound hematoma, scrotal oedema and hospital stay,resumption to normal activity was not significantly different (P>0.05) between patients operated by residents and consultants. Severity of post-operative pain (based on VAS scores) was also not significantly different (P>0.05) between patients operated by consultants and those operated by residents. Only 1 patient (1%) had recurrence of hernia after 6 months following hernia repair. Conclusion: Open mesh repair under local anaesthesia was a safe operation and the long-term results were acceptable among the patients operated by surgical trainees. There was no statistcally significant difference in the occurrence of post-operative complications except for increased operative time.


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