A long-term evaluation of the modified mesh-plug hernioplasty in over 2,000 patients

Background A modified technique for mesh-plug hernioplasty is a long-term, safe and efficacious treatment for primary unilateral inguinal herniorrhaphy. Methods Prospective analysis of 2,038 patients who underwent primary unilateral hernioplasty from 1997 to 2005 at a private university medical center. A modified technique using a mesh-plug was performed under local anesthesia with intravenous sedation. The modified technique consisted of placing the mesh plug into the preperitoneal space and suture fixation of the plug using the inner petals. The main outcome measures were Surgical morbidity, postoperative recovery, hernia recurrence, and chronic pain. Results There were 1,265 indirect and 773 direct hernias. Mean operative time was 28 min; mean recovery room time, 47 min. A total of 1,936 (95%) returned to normal activities within 3 days. Only 367 patients (18%) required prescription pain medication. Nine patients (0.4%) have been treated for chronic pain. No mesh infections or mesh migration have occurred. Three recurrences (0.15%) have been detected with a 99% follow-up over 2-10 years (mean 72 months). Conclusion The modified mesh-plug hernioplasty is a safe and efficacious treatment option for the primary unilateral inguinal hernia patient.