Primary inguinal hernia: The open repair today pros and cons

Abstract

Open anterior repair for inguinal hernia offers several distinct advantages over endoscopic repair, especially when real-world effectiveness is taken into account. The learning curve for endoscopic techniques is long, whereas the Lichtenstein and other open tension-free techniques are easier to teach and replicate at all levels. The outcomes of Lichtenstein repairs for primary inguinal hernia as performed by non-experts and supervised residents are comparable to those of experts. Moreover, open tension-free repair does not require expensive instruments or dedicated equipment, other than the prosthetic mesh. As such, it is feasible in any operating room anywhere in the world with limited costs. In our opinion, the most important advantage offered by open tension-free repair is that it can be performed under local anesthesia. Nevertheless, local anesthesia has some disadvantages: it requires training, excellent knowledge of the anatomy and the necessary technique, patience, and gentle handling of the tissues. Open inguinal hernia repair is a procedure that every surgeon should know and be able to perform because it is necessary to treat two conditions, groin hernia recurrence after a posterior approach (both laparoscopic and open) and pubic inguinal pain syndrome.

Groin Hernia-Revisited

“…The tension free concept got its brake through with Irving Liechtenstein, who used polypropylene meshes for posterior wall of inguailcanal. 3,7,8 Surgical repairs is the gold standard management in groin hernias, both congenital and acquired hernias. 8,9 Open herniotomy is the choice of repair in congenital hernia, associated with hydrocele, as both external inguinal ring and deep inguinal rings are closed to each other.…”

Validity of a low-cost Lichtenstein open inguinal hernia repair simulation model for surgical training

“…The open inguinal hernia repair technique is simpler to teach compared to the Electronic supplementary material The online version of this article (https ://doi.org/10.1007/s1002 9-019-02093 -6) contains supplementary material, which is available to authorized users. laparo-endoscopic techniques [6]. In many low-resource regions, laparoscopic surgery is not available.…”

Mesh fixation technique for inguinal hernia repair: protocol for an umbrella review with integrated and updated network meta-analysis

“…Clinical effectiveness of hernia repair is usually concerned with hernia recurrence, chronic groin pain, length of hospitalisation, recovery time and complications, e.g., surgical site infection, seroma and hematoma 3–6. These outcomes are very dependent on surgical techniques, patient’s factors and type of mesh/mesh fixation techniques 3 7…”