Open mesh-plug repair for primary inguinal hernia (826 cases)

The authors report their experience with open mesh-plug repair in the treatment of adult primary inguinal hernias from 1992 to 1998. Eight hundred and twenty-six cases, i.e.: 71% of all repairs for primary hernias, were operated using this procedure. 65.3% of all this operations were performed under local anesthesia (LA). The following complications were observed: wound infection 1.7%, haematoma 1.6%; orchitis 0.9%, recurrence 0.8%. The results were consistent with those of large series in the literature. Complications increased when anesthesia other than LA was used, in obese and in elderly patients. No patients required prosthesis removal due to pain or infection. We also discuss the various prostheses and our results favour polypropylene as opposed to Dacron. Several types of polypropylene mesh are discussed, comparing thickness, thread and pore size and their physical properties. The results suggest that a single thread close knit with controlled memory stiffness for the mesh and a looser and thinner version for the plug give the best results.