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Causes of recurrences after open inguinal herniorrhaphy

  • D. Ashrafi
  • M. Siddaiah-Subramanya
  • B. Memon
  • M. A. MemonEmail author



One of the most important measures of success of open inguinal herniorrhaphy is the incidence of recurrence. Reports suggest that up to 13% of all inguinal hernia repairs worldwide, irrespective of the approach, are repaired for recurrence. The reason as to why inguinal hernias recur is most likely multifactorial. The aim of this review is to evaluate the risk factors responsible for these recurrences in open suture and mesh techniques.


A search of the Medline, Embase, Science Citation Index, Current Contents and PubMed databases identified English language, peer-reviewed articles on the causes of recurrence following open inguinal herniorrhaphy published between 1990 and 2018. The search terms included ‘Inguinal hernia’; ‘Open methods’; ‘Suture repair’; ‘Mesh repair’, ‘Recurrence’, ‘Causes’, ‘Humans’.


The literature revealed several contributing modifiable and non-modifiable risk factors that were responsible for recurrence following open suture and mesh inguinal herniorrhaphy. These included perioperative, patient and hernia factors.


Despite the advent of laparoscopic techniques, open inguinal herniorrhaphy remains one of the most common surgical operations. With open inguinal hernia repairs, risk factors for recurrence can be broadly classified into perioperative, patient and hernia factors. Certain patient and technical risk factors are modifiable and could reduce the recurrence rate. However, many others factors are non-modifiable. It is therefore imperative that the outcome of open inguinal herniorrhaphy must be optimised by careful planning and education for both surgeons and patients to achieve the lowest possible risk of subsequent surgery for recurrence.


Inguinal hernia Open repair Suture repair Tissue repair Mesh repair Recurrence Human 


Compliance with ethical standards

Conflict of interest

DA declares no conflict of interest. MSS declares no conflict of interest. BM declares no conflict of interest. MAM declares no conflict of interest.

Ethical approval

No ethical approval is required as this is a literature.

Human and animal rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study, formal consent is not required.


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • D. Ashrafi
    • 1
    • 2
  • M. Siddaiah-Subramanya
    • 1
    • 3
  • B. Memon
    • 4
  • M. A. Memon
    • 1
    • 4
    • 5
    • 6
    • 7
    Email author
  1. 1.Mayne Medical School, School of MedicineUniversity of QueenslandBrisbaneAustralia
  2. 2.Sunshine Coast University HospitalBirtinyaAustralia
  3. 3.Charles Gardiner HospitalPerthAustralia
  4. 4.South East Queensland Surgery (SEQS) and Sunnybank Obesity CentreSunnybankAustralia
  5. 5.School of Agricultural, Computing and Environmental Sciences, International Centre for Applied Climate ScienceUniversity of Southern QueenslandToowoombaAustralia
  6. 6.Faculty of Health Sciences and MedicineBond UniversityGold CoastAustralia
  7. 7.Faculty of Health and Social ScienceBolton UniversityBoltonUK

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