The safety of mesh repair for primary inguinal hernias: results of 3,019 operations from five diverse surgical sources

Abstract

Initial attempts by surgical pioneers to repair hernias with prosthetic mesh met with failure because of faulty materials. As a result, surgeons experienced anxiety about performing this procedure. This anxiety persists, despite the present availability of new, safe patches and sutures. It was the unacceptably high failure rate of standard methods of repair for recurrent hernias that led to the use of plastic screens to bolster such repairs. However, persistent reluctance to use mesh for primary hernioplasty continued. Within the past two decades, true, tension-free patch repair of primary inguinal hernias without suture closure of hernial margins has been examined and clarified, and the technique has been perfected. In 3,019 reported primary inguinal hernias so treated by five different groups, there have been no mesh rejections, a 0.2 per cent recurrence rate, and insignificant incidence of infection. A new era of hernia repair appears to be at hand; therefore, such results warrant a new look at inguinal hernia repair.