الفهرس 
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Abstract
Inguinal hernia is the most common type of hernias; More than 70% of all hernia that occur are inguinal type. For practical purposes inguinal hernias have been classified into indirect and direct types. Clinically they may be asymptomatic, reducible, irreducible, incarcerated or painful, obstructed and strangulated.
The exact cause of inguinal hernia is still unknown but the following factors contribute in its occurrence. A congenital sac, raised intra abdominal pressure and weak abdominal musculature. There is no ”gold standard” operation for treatment of inguinal hernias. The optimal surgical approach must be selected individually for the patient, taking into account patient age, hernia size, unilaterality or bilaterality, primary or recurrent status, type of anesthesia, occupation, and patient activities.
There are three important landmarks in the history of repair of inguinal hernia:
a. Tissue repairs (Eduardo Bassini 1889). b. Onlay mesh (Irving Lichtenstein1984), tension-free repair. c. Laparoscopic hernia repair (1990). Laproscopic repair of inguinal hernia includes both TAPP and TEP approach.
The aim of this study is to evaluate hernioplasty of inguinal hernia with 3 stitches (minimal fixation) and asessment of postoperative pain , operative time , hospital stay, cost, morbidity & return to work and finally to compare this study with the traditional (Lichtenstein) method as regards to the recurrence rate, chronic post-operative pain and on other post-operative complications.
This study was done at Menoufiya university hospital over a period from August 2019 to August 2020, It included 40 patients complaining of inguinal hernia who were fit for surgery.
Patients were randomly divided into two groups:
group I were operated with traditional method (Lichtenstein inguinal hernia repair), (control group). group II were operated with the new technique (three stitches) mesh fixation with (2-0) prolene sutures as in Lichtenstein method but only with three stitches, (test group).
These patients presented in the outpatient clinics at Menofyia university hospitals, and distributed into 2 groups randomly.
All the two groups were compared for:
Operative duration. Intra-operative complications. Postoperative pain. Postoperative hospital stay. The mean time until return to work. Postoperative complications.
In patients who underwent traditional method (Lichtenstein inguinal hernia repair), the mean age was 37 years, the mean operative time was 45 min., the hospital stay was ranged from 1 to 2 days in all cases, with no recurrence in 4 months and they returned to work after 15 +/- 5 days.
In patients who underwent three stitch mesh fixation the mean age was 40 years, the mean operative time was 30 min, the hospital stay was 1 day, with one case of recurrence after 5 months and they returned to work after 15 +/- 5 days.
In this study the difference between the two groups regarding postoperative recurrence was statistically insignificant as one recurrent case in group I (5%), one case recurrent in group II (5%).
In this study that the differences between the two groups regarding postoperative pain were statistically significant, two cases in group I complaining of moderate pain postoperative (10%) while no cases presented with moderate pain in group II .