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Related Experiment Videos

[Inguinal hernia treatment]

M J Boudet1, T Perniceni

  • 1Département Médico-Chirurgical de pathologie digestive, Institut Mutualiste Montsouris, Paris. digestif@imm.fr

Journal De Chirurgie
|October 17, 1998
PubMed
Summary
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Groin hernia repair efficacy is best measured by recurrence rates. The Shouldice procedure shows the lowest recurrence, with no proven superiority of laparoscopic techniques over this surgical method.

Area of Science:

  • Abdominal surgery
  • Surgical outcomes
  • Hernia repair

Background:

  • Groin hernia repair efficacy is primarily assessed by recurrence rates.
  • Long-term follow-up (≥5 years, >90% complete) and surgeon examination are crucial for evaluating clinical results.

Purpose of the Study:

  • To review and compare the recurrence rates and postoperative pain associated with various groin hernia repair techniques.
  • To assess the comparative efficacy of open versus laparoscopic approaches and the role of prosthetics.

Main Methods:

  • Literature review of surgical techniques for groin hernia repair.
  • Comparison of recurrence rates for Shouldice, Lichtenstein, McVay, and various laparoscopic approaches (TAPP, TEP).

Main Results:

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  • The Shouldice procedure demonstrates the lowest recurrence rate among open herniorrhaphy techniques.
  • Laparoscopic transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) approaches have comparable recurrence rates to open methods and reduce postoperative pain.
  • No randomized controlled trials (RCTs) directly compare open suturing (raphies) with prosthetic techniques, nor have RCTs demonstrated laparoscopic superiority over the Shouldice procedure.

Conclusions:

  • The Shouldice procedure remains a highly effective open technique for groin hernia repair with low recurrence.
  • Laparoscopic techniques offer reduced postoperative pain but have not shown a definitive advantage in recurrence rates over established open methods like Shouldice.
  • Further high-quality RCTs are needed to definitively compare all available groin hernia repair strategies.