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Shouldice is superior to Bassini inguinal herniorrhaphy
M Kux1, N Fuchsjäger, M Schemper
1Department of Surgery, St. Joseph Hospital, Vienna, Austria.
American Journal of Surgery
|July 1, 1994
Summary
The Shouldice hernia repair method, particularly without permanent muscle sutures, demonstrated lower recurrence and complication rates compared to the Bassini method. This study highlights the Shouldice technique
Area of Science:
- Surgical Innovation
- Hernia Repair Techniques
- Clinical Outcomes Research
Background:
- The Bassini and Shouldice methods are standard inguinal herniorrhaphy procedures.
- Variations exist, including those omitting permanent internal oblique muscle suturing.
Purpose of the Study:
- To compare the original Bassini and Shouldice methods against their variants.
- To evaluate recurrence and complication rates based on surgical technique and risk factors.
Main Methods:
- Prospective allocation of 750 inguinal hernia repairs into four groups (Bassini/Shouldice with/without permanent muscle sutures).
- Correlation of outcomes with risk factors (direct hernia, recurrent hernia, hernia sac size, patient age, BMI, chronic bronchitis).
- Clinical examination for recurrence and complications in 93.6% of patients.
Main Results:
- Omitting permanent muscle sutures significantly reduced local complications (6.3% to 2.3%).
- Absorbable sutures in the modified Bassini group led to a high recurrence rate (12.8%).
- The Shouldice technique showed significantly lower 2-year recurrence rates (3.6%-2.3%) compared to the original Bassini method (8.7%).
Conclusions:
- The Shouldice technique is superior to the original Bassini method for inguinal hernia repair.
- Omitting permanent muscle sutures is physiologically sound and reduces complications.
- The Shouldice operation is recommended, especially when muscle sutures are omitted.