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From primary autogenous tissue repair to tension-free (mesh) repair. New meshes include composite, prolene, and biological.
A Lavender statement regarding inguinal hernia surgery in 2006 stated: “The elective treatment of asymptomatic or mildly symptomatic inguinal hernias in adults is a low priority treatment and patients will not be normally be offered surgery”.
Studies suggest watchful wait is as safe and effective as surgical repair in terms of groin pain and complications. The risk of strangulation remains low and a third of the total number on watchful wait came to surgery after a follow-up of 5 years. It is difficult to identify the group at higher risk of complications and strangulation.
Open methods of repair, currently in use:
This technique has been modified several times since it was first used. Recommended: 3-4 continuous passes along the inguinal ligament (a. Amid PK. Videosurgery and Other Miniinvasive Techniques 2009-4 25-31).
First time primary hernias should be repaired using the open approach. Laparoscopic repair of groin hernias should be offered to patients with bilateral hernias and recurrent hernias, and should be performed in specialist units.
Laparoscopic repair of inguinal hernias is currently restricted to: