Open Non-mesh Inguinal Hernia Repair

Abstract

Despite the fact that dozens of open inguinal hernia tissue repair techniques exist in the surgical literature, it is not currently a commonly performed technique in the United States. In the past quarter of a century, laparoscopic and open “tension-free” mesh inguinal hernia repairs have been a preferred approach for inguinal hernia repair. However, with an increased emphasis on other outcomes besides recurrence that impact the patient’s quality of life, in particular chronic pain, there is a growing interest in re-visiting non-mesh inguinal hernia repairs. Although not nearly as simple as thinking that mesh can cause chronic pain, it is possible that mesh may be a contributing factor in addition to many other factors, known and potentially not yet known, that result in a complication such as chronic pain. Other complications that may involve mesh as a contributing factor include infection, erosion, contraction, or migration that contributes to a recurrence and rare incidences of allergic-type and systemic/immune reactions. This chapter will highlight some of the established tissue repairs, discuss the reasons why they are of growing interest, and describe some of the general principles in performing a tissue repair.