Comparison of Early Postoperative Pain After Hernial Sac Ligation Versus Non-Ligation In Inguinal Hernioplasty

Syed Ali Haider, Raza Haider, Wardah Jabeen

  • Syed Ali Haider Department of Surgery, Dow Medical College & Dr. Ruth K. M. Pfau Civil Hospital Karachi



To compare the mean early postoperative pain scores in patients undergoing Inguinal hernioplasty with and without hernia sac ligation.

Study design

Randomised controlled trial.

Place & Duration of study

Department of General Surgery, Dr. Ruth K. M. Pfau Civil Hospital Karachi, from October 2019 to July 2021.


Patients undergoing inguinal hernioplasty for indirect incomplete inguinal hernia were randomly distributed in two arms. Patients in Group A had high ligation of hernia sacs whereas non-ligation and invagination of hernia sac was done in Group B. Similar postoperative management and pain relief was provided to both the groups. Postoperative pain score was recorded at 12, 24, 36 and 48 hours, using visual analogue scale (VAS).


Total of 70 patients were enrolled. Males constituted majority (n=77 - 95.7%) of the study population with similar distribution of gender in both the groups. The postoperative pain score at 12, 24 and 36 hours as well as overall mean pain score were less in Group B which was statistically significant. However, pain score at 48 hours was statistically insignificant between the groups.


Invagination of indirect inguinal hernia sac causes less postoperative pain in comparison to ligation/tansfixation of sac while being equally safe and time efficient.

Key words

Inguinal Hernia, Herniotomy, Sac Invagination, Postoperative pain.