Inguinal hernia: a comparison of common techniques

Between July 1995 and June 1996, 280 patients were operated on for inguinal hernia within the scope of a prospective, randomized study. The aim of the study was to compare the Shouldice technique with tension-free hernioplast y (Lichtenstein, TAPP). The operation time was comparable in all three grou ps. There was less need for analgesics and postoperative morbidity was less after the tension-free technique. No severe complications such as deep wou nd infection or infection of the implant were seen in any of the groups. Af ter a follow-up period of 18 months, we found two recurrences after the Sho uldice operation and one recurrence in each of the tension-free groups. Tre atment satisfaction after tension-free hernioplasty was high. One year afte r the Shouldice operation, about 10% of the patients were dissatisfied beca use of persistent discomfort and pain. Because of lower morbidity, less pai n, and low recurrence rates after tension-free hernioplasty, we find the te nsion-free techniques to be superior to conventional hernioplasty.