Is open surgery still part of the current treatment of inguinal hernias?

Abstract

Inguinal hernia repair represents one of the most frequent pathologies with surgical addressability. From the multitude of surgical procedures, a limited number still keep their indication in the current treatment of hernias. Open surgery, the exclusive repair method until recently, is associated with laparoscopic techniques with benefits that are at least superposable on those in open repair. We conducted a study, analyzing several types of procedures in open surgery and comparing them to each other, but also with the TAPP approach, which is still at the beginning in our service. The non-mesh procedures scored poorly in terms of recurrence, the duration of the surgical intervention, and complications of the pain type, the Lichtenstein procedure was frequently associated with non-infectious inflammatory complications, and the TAPP, which is still in the learning curve, presented a prolonged duration of the surgical intervention. The Lichtenstein procedure maintains its usefulness and represents the most frequent technique for sanctioning inguinal hernia, the non-mesh processes, less used lately, are more frequently preferred in situations where hernia strangulation is associated with a septic complication. Open surgery hernia repair remains a feasible option in the era of minimal invasiveness, especially under the conditions of performing a tension-free technique, for specific categories of patients or surgical services remaining the first intention solution.

Keywords

• inguinal hernias
• open surgery
• current treatment
• lichtenstein
• bassini
• shouldice
• desarda