To compare the different effect of with or without mesh placement in inguinal canal on pain after Gilbert repair.

From February 2014 to February 2017, 269 cases unilateral hernia underwent Gilbert repair in the second hospital of Jiaxing were divided into traditional Gilbert group (meshes were placed in preperitoneal space and in the inguinal canal) and modified Gilbert group (the mesh was placed in the preperitoneal space only). The postoperative short-term pain, postoperative chronic pain, incidence of different pain nature and recurrence rate during the short-term follow-up were compared between the two groups.

And there were no significant differences in the recurrence rate between the two groups during the short-term follow-up period (P=1.000). In the traditional Gilbert group, there were 158 cases of short-term pain, of which 30 cases were moderate and 7 cases were severe. There were 44 cases of CPIP, of which 17 cases were moderate and 6 cases were severe. In the modified Gilbert group, there were 32 cases of short-term pain, of which 2 cases were moderate and 1 cases were severe. There were 4 cases of CPIP, of which 1 case were moderate and none was severe. The modified Gilbert group showed lower incidence of short-term moderate and severe pain, lower overall incidence of CPIP, lower incidence of moderate and severe CPIP, and lower incidence of CPIP induced by the activities than the traditional Gilbert group, the differences were statistically significant (P=0.034, 0.048, 0.036, 0.049).

The modified Gilbert which mesh is placed in preperitoneal space only without mesh placed in the inguinal canal can effectively reduce the incidence of moderate and severe pain in the short-term after Gilbert repair, the overall incidence of postoperative chronic pain, and the incidence of moderate and severe chronic pain after Gilbert repair, and the incidence of chronic pain induced by the activities after Gilbert repair. Moreover, it doesn't increase in the rate of hernia recurrence during the short-term in follow-up after Gilbert repair.