Tension-free inguinal hernia repair: a retrospective study of 3000 cases in one center

The tension-free anterior repair of inguinal hernia using a mesh, initially described by Zagdoun in 1959 and perfectly described by Lichtenstein, was used as a basis for the technique we adapted 17 years ago. The purpose of this study was to retrospectively assess the clinical long-term results of this modified tension-free technique. Three thousand inguinal hernias were operated by the same surgeon. The Lichtenstein technique modifications were the nature and the enlarged size of the mesh (polyester-Parietex, 13 x 9 cm) and the fixation method (staples). Complications, pain, and recurrence were carefully reported on a standardized file. Immediate complications were rare and always minor: hematomas and parietal abscesses. With a mean follow-up of 8 years, 48 cases of persisting pains (2%) coming from nervous irritation were reported, and only 12 recurrences (0.5%) were detected more than 10 years after surgery. Based on follow-up of these 3000 hernias, the results of this study exhibit a very low rate of recurrence (0.5%). This technique seems to be easy, painless, safe, and effective.