What are surgical technique options for open inguinal hernia repair?

Updated: Jan 17, 2018
  • Author: Vinay Kumar Kapoor, MBBS, MS, FRCS, FAMS; Chief Editor: Kurt E Roberts, MD  more...
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Other approaches to open inguinal hernia repair include the following:

  • Plug-and-patch repair - This adds a polypropylene plug shaped as a cone, which can be deployed into the internal ring after reduction of an indirect sac
  • Prolene Hernia System (PHS) - This consists of an anterior oval polypropylene mesh connected to a posterior circular component
  • McVay repair - In this approach, the conjoined (transversus abdominis and internal oblique) tendon is sutured to the Cooper ligament with interrupted nonabsorbable sutures
  • Bassini repair - This approach involves suturing the transversalis fascia and the conjoined tendon to the inguinal ligament behind the spermatic cord, as well as placing a vertical relaxing incision in the anterior rectus sheath
  • Shouldice repair - This is a four-layer procedure in which transversalis fascia is incised from the internal ring laterally to the pubic tubercle medially, upper and lower flaps are created and then overlapped with two layers of sutures, and the conjoined tendon is sutured to the inguinal ligament (again in two overlapping layers)
  • Darn repair - This is a pure-tissue tensionless technique that is performed by placing a continuous suture between the conjoined tendon and the inguinal ligament without approximating the two structures

See Technique for more detail.

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