[A surgical cure of inguinal hernias by the Shouldice procedure]

Shouldice procedure became an elective technique in inguinal hernia repair as a consequence of the spectacular results of the Shouldice Hospital in Toronto (less 1% recurrence rate) and of other surgical centres in USA or western Europe. In the present study 73 cases of uncomplicated inguinal hernias who underwent a Shouldice herniotomy are analysed within a period of three years. Cremaster resection was routinely performed preserving a one inch proximal fragment which was used to calibrate the inguinal ring after reconstruction. Two continuous nonresorbable stitches were used to reinforce the posterior wall, as described by the author. Short postoperative follow-up showed good results in 64 cases but only 21 patients were reviewed within 6 and 12 month. Nevertheless no recurrence was reported in 3 years by any patient. According to these encouraging results Shouldice procedure might be considered as the procedure of choice in the treatment of inguinal hernias but much more data are necessary for pertinent conclusions.