"Tension-free" inguinal herniorrhaphy: a preliminary report on the "mesh plug" technique

Abstract

Background: Since 1984 we have completed 3897 inguinal herniorrhaphies. This article compares our results with a conventional Cooper ligament repair versus the "mesh hernia plug" method.

Methods: From 1984 through 1988 we performed 2886 conventional Cooper ligament repairs. From 1989 through 1991 we completed 1011 mesh hernia plug repairs.

Results: Despite an acceptable recurrence rate (1.8%), we abandoned the Cooper ligament technique because of persistent difficulties with immediate postoperative pain, inability to reasonably resume day-to-day activities, delayed capacity regarding return to work, and four cases of femoral vein compression. Of the hernias repaired by the mesh plug method, the recurrence rate remains remarkably low (0.2%), and except for four superficial infections and three cases of urinary retention, no other significant complications have been reported.

Conclusions: Compared with conventional sutured surgical techniques, a plug repair uses less overall dissection and ensures a "tension-free" hernioplasty. We believe that the two factors of no tissue tension and decreased dissection are the most important reasons for greater patient comfort, rapid rehabilitation, decreased recurrence, and lessened overall complication rates with the mesh hernia plug technique.