Farooq Ahmad, Muhammad Zahid, Hasan Askri, Muhammad Iqbal.
Comparison of inguinal hernia repair under local anesthesia by surgical trainees and consultants.
Esculapio J Services Inst Med Sci Jan ;9(2):70-4.

Objective: To evaluate the outcome of Lichtenstein repair under local anesthesia in term of safety, efficacy and complications and to compare the results of surgical trainees with their consultants. Material and Methods: All Consecutive patients with primary inguinal hernia undergoing Lichtenstein repair under local anesthesia by our trainees and consultants over a 05 year period were included into the study. Operative time, hospital stay and complications were assessed. Data was analyzed using SPSS version 17. Results:A total of 298patients were included in the study; 15 patients were excluded from the study due to loss of follow up. Data analysis has been done for 283 patients. All the study subjects were male with a mean age of 39.28 ± 12.61 years. Indirect inguinal hernia (91%) was the commonest, followed by direct inguinal hernia (6.7%) and sliding hernia was only in 1.6% of the patients. Majority of the hernia repairs 221(78%) were performed by the residents and only 62(21.9%) were performed by the consultants. The operative time was slightly more for residents 46.8 versus 42.8 minutes (P<0.05); whereas hospital stay was comparable between the two groups 1.23 versus 1.27 days (P=0.562). Minor postoperative complications occurred in 24(8.5%) patients. Wound infection, scrotal hematoma and chronic pain were the most common complications in 1.4% patients. All these complications were managed conservatively including wound infection. However recurrence occurred in 2(0.7%) patients of residents group. Conclusion: Inguinal hernia can be safely repaired under local anesthesia and it is one of the procedures that can be safely delegated to surgical trainees with comparable results with consultants.

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