Balakh Sher Zaman, Muhammad Faheem Anwer, Muhammad Usman Aslam, Ahsen Nazir Ahmed, Abul Fazal Ali Khan, Salman Arif.
Hernial SAC Ligation in Hernioplasty of Indirect Hernia - A Needless Step.
J Fatima Jinnah Med Coll Lahore Jan ;7(2):22-5.

Objectives. To evaluate the effect of high sac ligation in Lichtenstein Indirect inguinal hernia repair on post operative pain. Methodology: This study consisting of 100 patients of clinically diagnosed right or left indirect inguinal hernia with age ranging from 16-80 yrs, was conducted in the department of surgical unit II, Jinnah Hospital, Lahore. Patients were divided randomly in two equal groups. Group A included patients undergoing high sac ligation while group B included patients of sac reduction. The main outcome measure was mean postoperative pain score using visual analog scale on 1st, 7th and 10th post operative days. Results: 78% of the patients were between 20 to 50 yrs of age with male to female ratio 99:1. 60% of the patients had presented with right inguinal hernia and 40% with left inguinal hernia. Postoperatively mean pain scores in patients who underwent sac reduction were 3.30 + 0.70 on 1st post op day, 2.22 + 0.58 on 7th and 0.32 + 0.47 on 10th post op day, while mean pain scores in patients who underwent high sac ligation were 4.34 + 0.82 on 1st post op day, 3.34 + 0.64 on 7th and 2.40 + 0.53 on 10th post op day. Conclusion: Ligation of the hernial sac in inguinal hernia surgery is not only unnecessary and time consuming but also leads to increased post-operative pain.

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