Prospective randomized study for pain outcome after modified Kugel Mesh repair versus lichtenstein repair

Background: modified kugel hernia repair is minimal access surgery with open preperitoneal approach for inguinal hernia is better and without the disadvantages of laparoscopic procedure methods a total of 86 patients with primary inguinal hernia were randomized to undergo the open preperitoneal modified kugel or the open anterior lichtenstein procedure in mayo hospital. the outcome measures were operating time,pain on visual analog scale (vas) and consumed analgesics during the first fifteen days postoperatively and at 04 months time. results in modified kugel repair group the operation took less (42 minutes versus 55 minutes; p< .001) there were no difference in pain score or usage of analgesia in either group in first 15 days postoperatively. in lictinstein repair the mean pain score at 4 months was about 0.9 versus 0.3 of modified kugel group with p= .002. the patients reporting for pain postoperatively were 4.34% versus 40% for modified kugel repair and lictinstein repair respectively p=.004.as more chances of damage to nerve in lictinstein repair,so more cases reported with numbness and paresthesia in area of nerve distribution in this group. conclusions: modified kugel procedure is better alternative to lichtenstein repair of inguinal hernia as it is less associated with chronic pain at 120 days. neurological pain and paresthesia or numbness in lichtinstein repair is due to risk of nerve damage during anterior approach.