MESH PLUG REPAIR - A SIMPLE, RAPID AND UNCOMPLICATED TECHNIQUE FOR INGUINAL-HERNIA MANAGEMENT

Introduction: The optimal inguinal hernia repair technique is a matter of debate. The Shouldice operation has long been regarded as the gold standard. While specialized hernia clinics have reproduced good resul ts, a recurrence rate for trainees and non-specialized surgeons of bet ween 10% and 15% seems to be more common. Laparoscopic hernia surgery has brought decreasing postoperative morbidity, low postoperative disa bility and early return to work. These advantages of a tension-free te chnique are due to the use of a prosthetic mesh. It is largely the eff orts of Gilbert, Lichtenstein and Rutkow/Robbins which have popularize d the use of prosthetic mesh by an open anterior approach in the USA. Methods: Since January 1997 we have prospectively evaluated the open m esh plug repair described by Rutkow/Robbins in Basel and Lugano. We ha ve operated on 110 patients (103 male, 7 female). All patients were in terviewed 4 weeks postoperatively at our clinic. Results: There were n o major complications. Two patients underwent reoperation for drainage of a haematoma. There was no early recurrence or infection. After 4 w eeks 82% of all patients were back to normal activity. An early return to work has been noted (10 days on average for sedentary workers). Co nclusion: The main advantages of this technique are simplicity, low co st, reduced postoperative disability and early return to work. It is m uch too early to say anything concerning recurrence in this series.