[Lichtenstein patch versus Shouldice technique in primary inguinal hernia with a high risk of recurrence]

209 primary inguinal hernias in patients older than 60 years with high risk for recurrence and for surgery were randomly allocated to Shouldice repair (107 hernias) or Lichtenstein patch (102 hernias). Over a 30 months period there was one recurrence in the Lichtenstein group. The amount of local anesthetic and postoperative pain medication was significantly reduced in the Lichtenstein group, 9.8% of repairs requiring no pain medication at all, and 29.4% none on the first postoperative day. No other hernia repair is as painless, innocuous, and easily performed under local anesthesia as the Lichtenstein patch. Both, Lichtenstein and Shouldice, serve their purpose almost ideally when done correctly.