INGUINAL-HERNIA REPAIR

Efficacy of groin hernia repair is mainly evaluated by its recurrence rate. In the literature it depends on the type of surgery but also on the follow-up, which must last 5 years at least and has to be more tha n 90 % complete. To acertain the clinical result, the patient must be examined by a surgeon. Among herniorraphies techniques, Shouldice proc edure has the lowest recurrence rate. The Lichtenstein operation leads to less recurrence rate than Me Vay's, for mixt (direct and indirect) hernias. Post operative pain might be diminished after the former pro cedure. No randomized central trial has compared raphies and technique s involving a prosthesis, in groin hernia repair. Among laparoscopic t echniques, the transabdominal and preperitoneal approaches have less r ecurrence rate than the entirely intra peritoneal one, which has been abandonned. Their recurrence rate is not different than recurrence rat e of herniorraphies and techniques using a prosthesis. With them, post operative abdominal pain is diminished. Nevertheless no randomized co ntrol tial has demonstrated any superiority of laparoscopic techniques on the Shouldice procedure.