What are inguinal hernias and what is the frequency of open surgical repair?

Updated: Jan 17, 2018
  • Author: Vinay Kumar Kapoor, MBBS, MS, FRCS, FAMS; Chief Editor: Kurt E Roberts, MD  more...
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Answer

Hernias are abnormal protrusions of a viscus (or part of it) through a normal or abnormal opening in a cavity (usually the abdomen). They are most commonly seen in the groin; a minority are paraumbilical or incisional. In the groin, inguinal hernias are more common than femoral hernias.

Inguinal hernias occur in about 15% of the adult population, and inguinal hernia repair is one of the most commonly performed surgical procedures in the world. [1] Approximately 800,000 mesh hernioplasties are performed each year in the United States, [2] 100,000 in France, and 80,000 in the United Kingdom.

There is morphologic and biochemical evidence that adult male inguinal hernias are associated with an altered ratio of type I to type III collagen. [3] These changes lead to weakening of the fibroconnective tissue of the groin and development of inguinal hernias. Recognition of this process led to acknowledgment of the need for prosthetic reinforcement of weakened abdominal wall tissue.

Given the evidence that the use of mesh lowers the recurrence rate, [4, 5] as well as the availability of various prosthetic meshes for the reinforcement of the posterior wall of the inguinal canal, most surgeons now prefer to perform a tension-free mesh repair. Accordingly, this article focuses primarily on the Lichtenstein tension-free hernioplasty, which is one of the most popular techniques used for inguinal hernia repair. [6, 7]


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