[Surgical repair of inguinal hernia in the adult Clinical, functional, and economic outcomes of surgical practices]

Abstract

Inguinal hernia repair is the most commonly performed surgical procedure. Nearly one out of three men between 20 and 60 years of age will undergo hernia repair. Multiple surgical techniques are available which have comparable clinical outcomes but which differ in their functional results and economic impact. Despite an extensive surgical literature, no consensus exists regarding an optimal technique. This review aims to compare the indications for the three most common techniques: 1) the Shouldice repair, 2) the Lichtenstein repair, and 3) the laparoscopic hernia repair. To begin with, we present the operative principals of each repair along with criteria for evaluation of outcomes. Evidence-based outcomes data are then presented. We then address the choice of a surgical technique for everyday practice based on these factors. Finally, we propose avenues for future clinical research which may improve clinical, functional, and economic results in the repair of inguinal hernia of the adult.