title: Effect of peritoneal incision on immediate pain after inguinal hernia repair: A Prospective Cohort Study.
abstract: OBJECTIVE
  Hernia repair is a common surgical procedure, and postoperative pain is an inevitable result of hernia surgery. The prevention of postoperative pain is of considerable importance in terms of patient comfort and early discharge. In this study, we evaluated the effects of a peritoneal incision on pain in the early postoperative period.
  
  
  BACKGROUND
  This was a prospective clinical study with 75 patients undergoing inguinal hernia repair.
  
  
  METHODS
  Patients were divided into five groups: group 1: indirect hernia, Lichtenstein repair with peritoneal incision, group 2: indirect hernia, Lichtenstein repair without peritoneal incision, group 3: all hernias, trans-abdominal preperitoneal(TAPP) repair, group 4: all hernias, total extraperitoneal (TEP) repair, and group 5: direct hernia, Lichtenstein repair with no peritoneal incision. Groups were compared in terms of postoperative pain scores at three different times and complications.
  
  
  RESULTS
  There were 62 males and 13 females; their average age was 51.25 years. The visual analog scale (VAS) scores were lower in groups 2, 4, and 5, and there were differences among groups and within each group according to VAS changes assessed at all time points (p < 0.05). There was no difference, according to VAS analysis, between open and laparoscopic surgery groups. There was a difference according to VAS changes in each group between hernia sides (p < 0.001).
  
  
  CONCLUSIONS
  Peritoneal incision is a significant risk factor for postoperative pain after inguinal hernia repair. But, surgical procedure was not a risk factor although VAS scores were higher in open than laparoscopic surgery.
authors.affiliation: a Zonguldak Ataturk State Hospital, Zonguldak, 67100, Turkey.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Tanrikulu
authors.affiliation: b Zonguldak Atatürk State HospitalDepartment of General Surgery.
authors.forename: Mithat
authors.initials: M
authors.lastname: Cagsar
authors.affiliation: c Zonguldak Atatürk State HospitalDepartment of General Surgery.
authors.forename: Boran
authors.initials: B
authors.lastname: Yalcin
authors.affiliation: d Bulent Ecevit University, Faculty of Medicine, Department of Emergency Medicine.
authors.forename: Furuzan
authors.initials: F
authors.lastname: Kokturk
authors.affiliation: e Zonguldak Atatürk State HospitalDepartment of General Surgery.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Yilmaz
authors.affiliation: f Zonguldak Atatürk State HospitalDepartment of General Surgery.
authors.forename: Volkan
authors.initials: V
authors.lastname: Temi
keywords: Inguinal hernia; inguinodynia; mesh hernia repair; postoperative pain.