Elective inguinal hernia repair during Operation Iraqi Freedom

While there have been many publications regarding trauma care in the deployed environment, there is little discussion on the management of the more mundane maladies. This article examines the role of elective surgical intervention for inguinal hernia repairs within theater. Current U.S. policy transports service members out of theater for elective repair and convalescence. In these times of limited man power, this can represent a significant loss of the fighting strength.

Between January 2006 and July 2006, military surgeons at the 47th Combat Support Hospital in Iraq repaired 11 inguinal hernias. All patients were encouraged to resume normal duty and physical training as soon as possible. A post-procedure questionnaire was completed 6-12 months after surgery.

Four repairs were completed with the Prolene Hernia System (PHS; Ethicon, West Somerville, NJ) and seven repairs using the plug and patch method (C. R. Bard, Inc., Murray Hill, NJ). Ten patients were available for follow-up. There were no wound infections, nerve injuries, or recurrences. Patients returned to full duty within 3 days to 6 weeks.

Based on our experience and the feedback from our patients, no complications were noted in this small population of elective hernia repairs. Further prospective trials with long term follow-up are needed to confirm these initial findings.