Triple-combined herniorrhaphy for inguinal hernia repair: experience of 1411 cases

The optimum method for inguinal hernia repair has not yet been determined. Triple-Combined Herniorrhaphy, using the combined methods of McVay, Shouldice and Halsted repairs, was developed in our hospital over the past years in order to improve the overall results of treatment of inguinal hernia. The aim of this study was to verify the value of this surgical technique for primary inguinal hernia in a specialized hospital setting.

We describe our experience of 1411 consecutive patients for whom Triple-Combined Herniorrhaphy was performed for inguinal hernia repair at our hospital between September 2000 and August 2003, under local anesthesia with a "one-day surgery" regimen.

The type of hernias included 342 direct inguinal hernias, 913 indirect inguinal hernias, and 156 pantaloon (mixed) type inguinal hernias. No mortality or major intraoperative complications were observed. The median duration of operation time was 25 min. Wound infection and hematoma formation requiring drainage was observed in 9 and 16 patients, respectively. Patients had fast convalescence with rapid resumption of working activity. The postoperative recurrence rate was 1.2%.

Triple-Combined Herniorrhaphy is a simple, safe, comfortable, and effective method with low early and later morbidity and recurrence rate. The good results of this procedure constitute a good alternative to mesh or other open inguinal repairs.