Hernias represent a common surgical concern with an uncertain exact frequency. Approximately 80% of all hernias manifest in the inguinal region, with two-thirds classified as indirect inguinal hernias and the remaining third as direct inguinal hernias [1]. The likelihood of developing a groin hernia is notably higher in men, being 20 times more susceptible than women. Regardless of gender, the most prevalent type is the indirect inguinal hernia, with men having a ratio of 2:1 for indirect to direct hernias. Direct hernias are rare in women, and men face an approximate 20% chance of developing a groin hernia compared to women’s risk of less than 5%. Notably, indirect inguinal hernias tend to occur more frequently on the right side due to delayed atrophy of the processus vaginalis [2].

The occurrence of inguinal hernias varies worldwide, influenced by differences in population age distribution, access to surgical care, and the risk of fatal outcomes. The global mortality rate associated with inguinal hernias is considerable, with over 60,000 individuals succumbing to hernia-related complications annually. The exact triggers for inguinal hernias in adults are still under discussion, but acquired weaknesses in the abdominal wall are believed to play a significant role. Various risk factors contribute, with a common factor being a weakness in the musculature of the abdominal wall [3].

One intriguing area of research focuses on the influence of tissue biology in hernia development. Limited data, especially regarding the molecular underpinnings of inguinal hernias, is available. Studies examining the skin of patients with inguinal hernias have shown markedly reduced ratios of type I to type III collagen. While much remains to be understood about the biological aspects of hernias, these investigations provide compelling evidence for a potential genetic collagen defect [4].

In this research endeavor, we have employed a prospective longitudinal study design, allowing us to observe and collect data over eight months. Our sample comprises 40 participants, evenly divided into two groups: 20 individuals will undergo laparoscopic procedures, while the remaining 20 will undergo open surgery. Carefully allocating participants into these distinct surgical approaches will enable us to comprehensively assess and compare their outcomes, contributing valuable insights to our study’s objectives over the designated time frame.

The inclusion criteria for this study encompass a specific set of parameters. Firstly, the study includes elective cases conducted at the Medical Orthopedic and Trauma (M.O.T.) facility, ensuring that the surgical procedures are planned and not emergent. The surgical approaches under consideration involve Inguinal Hemiarthroplasty, techniques such as Transabdominal Preperitoneal (TAPP) or Totally Extraperitoneal (T.E.P.), and Lichtenstein’s Mesh repair. Patients aged 15 to 75 years are eligible for participation, encompassing a broad spectrum of adult age groups. Both unilateral and bilateral cases of inguinal hernias are considered, allowing for a comprehensive evaluation of different hernia presentations. Additionally, the study emphasizes primary cases, focusing on initial occurrences of inguinal hernias rather than recurrent or secondary cases, maintaining a consistent and specific research scope.

The exclusion criteria for this study are straightforward and singular. Patients who have previously experienced recurrent hernias are intentionally excluded from participation. This exclusion ensures that the study specifically focuses on primary cases of inguinal hernias without the influence of prior surgical interventions or relapses. This allows for a more precise examination of the targeted research objectives.

For this study, 40 cases involving primary inguinal hernias were carefully selected as participants. Ethical approval from the committee and informed consent from each patient were diligently obtained, ensuring compliance with ethical standards. Upon admission, patients displaying clinical evidence of inguinal hernias underwent a comprehensive evaluation, which included a detailed medical history and physical examination. Routine investigations, such as complete blood count, blood sugar level, serum creatinine, chest X-rays, and E.C.G.s, were conducted to gather essential baseline data. In cases where findings were inconclusive or other pathologies were suspected, additional investigations, such as abdominal ultrasonography and C.T. abdomen scans, were carried out to provide a more comprehensive understanding. The study’s inclusion and exclusion criteria were thoughtfully defined. They rigorously adhered to, ensuring that only eligible cases were included in the research, thereby maintaining the study’s integrity and relevance to the specific objectives.

In the study, a total of forty patients were enrolled, with the gender distribution showing a notable predominance of male participants. Specifically, there were 39 male patients, constituting 98.33% of the study population, while only one female patient, making up 1.67% of the total participants, was included in the research. Table 1 presents sex distribution in patients studied.

The occupation distribution among the participants in this study showcased a variety of professions. The majority of patients identified as agriculturists, comprising 33.33% of the study population. Approximately 20% were engaged in small-scale business ventures, while 10% were involved in factory or tea garden work. An equal percentage, totaling 10%, were unemployed individuals, providing a diverse representation of occupations within the research cohort. Table 2 shows occupation distribution of patients studied.

In this study, a significant majority of cases, accounting for 70%, exhibited swelling confined to the inguinal region. Conversely, the remaining 30% of cases presented with an inguinoscrotal swelling, indicating a varied manifestation of the hernias under investigation. Table 3 shows the site of swelling of patients in study.

Rutkow [5] conducted a comprehensive analysis of inguinal hernia demographics, revealing a substantial gender distribution, with 90% of cases occurring in males and the remaining 10% in females [5]. Similarly, Kurzer et al.’s study at the British Hernia Centre indicated a male predominance, comprising 96% of cases, with females constituting the remaining 4% [6]. These studies collectively underscore the male predominance in inguinal hernia incidence [7, 8]. Shyam and Rapsang’s prospective study in Shillong, India, focused on 59 male patients with inguinal hernias, further supporting the trend of male predominance, accounting for 100% of the cases [9].

Our study also revealed a significant gender distribution, with 97.33% male participants and 2.67% female participants [10, 11]. While this sex incidence differs from studies in other regions, it aligns closely with findings within our specific geographical area. Regional variations in inguinal hernia prevalence highlight the importance of considering local demographics and factors in healthcare research and practice. Observations by Sanjay and Woodward [12] and Salcedo-Wasicek and Thirlby [13] regarding the relationship between occupational factors and inguinal hernias align with our findings. In our study, 33.33% of cases were agriculturists, 10% were engaged in small-scale businesses, and 15% were factory workers, resembling patterns observed in the mentioned studies. This correlation emphasizes the role of occupational factors in inguinal hernia incidence.

In our study, 72.67% of cases presented with an indirect inguinal hernia, while the remaining 27.33% presented with a direct inguinal hernia. These findings are consistent with earlier studies, suggesting the higher prevalence of indirect inguinal hernias. This similarity reinforces the notion that indirect inguinal hernias are more common among individuals in these studies.

Our study highlights the highest incidence of inguinal hernias among males, comprising 39 males and one female in the study population. The mean age at presentation was approximately 44.86 years. Additionally, a significant proportion of cases were engaged in occupations involving moderate to challenging physical activities. These findings underscore the prominence of inguinal hernias among males and emphasize the potential influence of physically demanding occupations on hernia occurrence in the study population.

This research paper received no external funding.

The authors declare no conflicts of interest.

All authors contributed equally to this paper. They have all read and approved the final version.

Informed consent was obtained from all participates in the study as needed.

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