title: Recent Trends in Dealing with Inguinal Hernial Sac.
abstract: High ligation of the hernial sac is a hallowed and time-honoured concept in inguinal hernia repair and it is considered essential for preventing recurrence. However, this concept has been contested in recent reports. We conducted a prospective study of 186 cases of inguinal hernia repair. In 92 cases the sac was ligated at the neck and excised, in 94 cases the sac was not ligated at all but either simply inverted or excised without ligation. The type of repair was Bassini's repair, Shouldice repair or Lichtenstein's repair. Degree of post-operative pain was significantly less in those cases where sac was not ligated. There were no cases of recurrence in either group at 3 years follow up. Ligation of sac in inguinal hernia surgery is not only unnecessary and time consuming but also leads to increased post-operation pain. Recurrence is unaffected by not ligating the sac.
authors.affiliation: Senior Advisor (Surgery), 92 Base Hospital, C/o 56 APO.
authors.forename: P J
authors.initials: PJ
authors.lastname: Vincent
authors.affiliation: Commandant, Military Hospital, Agra Cantt.
authors.forename: Y
authors.initials: Y
authors.lastname: Singh
authors.affiliation: Associate Professor, Department of Surgery, Armed Forces Medical College, Pune 411 040.
authors.forename: C S
authors.initials: CS
authors.lastname: Joshi
authors.affiliation: Associate Professor, Department of Surgery, Armed Forces Medical College, Pune 411 040.
authors.forename: A K
authors.initials: AK
authors.lastname: Pujahari
authors.affiliation: Classified Specialist (Surgery & Paed Surgery), 166 Military Hospital, C/o 56 APO.
authors.forename: M M
authors.initials: MM
authors.lastname: Harjai
keywords: Hernial sac; Recurrence