Page 62 - herina surgery and possible lawsuits

• Picchio studied post hernia surgery pain and found 28% complained mild pain, 17%

moderate pain, and 6% severe pain at the 1-month follow up. After 6 months, the
numbers were 25, 9, and 3%, and after 1 yr 18,4, and 2%, respectively.[123]
• Jaiswal et al (India) found 0.78% had mild chrome pain and well controlled with oral

analgesics with minimal follow up of six months and concluded incidence of chronic
pain was less and less disabling than what is generally reported. [19]
• Bhattacharjee et al had studied the discomfort & pain after 5-7 years found that

significant groin discomfort was described by 6% patients with 3% had restricted
daily activity after plug and patch repair, concluded that significant restricting groin
symptoms were uncommon. [17]

• There was no correlation between the incidences of pain in relation to follow up, but
with time the seventy of pam decrease, suggesting “bum out1 effect of the pain

complaints.[14]
• Courtney et al studied severe chrome pain following hernia repair and concluded that
chronic pam persists in most of patients who report severe or very severe pam at 3
months after hernia repair. [91]

• There was an overall decrease in pam with time, from 29.7% at 6-12 months to 18.1%
at 37-48 months after surgery. Pain was more common m patients younger than 40

years of age.[116]

Chronic pain in relation to experience of surgeon:

• Alfien et al reported moderate to severe pain at 6 months m 1.9% (17/856)

surgery done by senior surgeons and 3.4% (4/117) by residents (P=0.14).[15]
• Other study suggested that there was significant impact of training of resident
on recurrence m open repair but not on other complications. Recurrence rate

was more than 5% m first year of training but achieved nearer to 1% after 4
years of framing. [132]
Chronic pain in relation to recurrent hernia:

Most of the study had combination of patients having primary and recurrent hernia,
and data did not specify chrome pain incidence separately. Only few studies have compared
the chronic pam risk m both groups.

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