[Surgery for inguinal hernia: indications and operative principles]

Abstract

During the last century, many surgical techniques have been reported for inguinal hernia repair. The goal of theses methods is to repair or reinforce the posterior wall of inguinal canal. The raphies performed by suturing and closing the inguinal ring may lead to excessive tension resulting in pain and recurrence. The use of prosthetic mesh reinforces the posterior wall and allows tension-free repair whether performed by inguinal route or laparoscopically. No consensus has yet been reached about the best surgical approach to inguinal hernia repair in view of the literature (especially randomised-controlled trials). Mesh repairs are associated with a low recurrence rate. Laparoscopy seems not to be superior to open mesh repair. Therefore, it is not possible to use only a single technique and the surgeon must adjust the choice of repair to each patient.