Four years’ experience of one centre in mesh-plug inguinal hernia repair

Aim of work: Mesh-plug hernioplasty is one of the preferred methods of hernia repair, with a recurrence rate of about 1%. The authors investigated the correlation between type of hernia and complications such as recurrence or chronic pain.
Materials and methods: Between 1999 and 2002, 375 patients were operated on for inguinal hernia using the mesh plug procedure. Assessment of the patients was performed prospectively; the follow-up period was 1 to 5 years (median 3). The primary outcome measurements were the rate and timing of recurrence, and incidence of chronic pain.
Results: A total number of 6 recurrences occurred (1.6%). Rate of recurrence for direct hernia was 5.31% and for indirect 0%. All the recurrences occurred within the first year after operation (mean 4.5 months). In all cases recurrent hernias were found in the Hasselbach triangle. Overall chronic pain rate reached 23% and was higher in small indirect hernias than in direct ones. This difference was not statistically significant (p=0.834).
Conclusions:
The relatively high recurrence rate of direct hernias questions the application of the mesh plug technique to this type of inguinal defect. Additionally, the high percentage of patients with chronic pain warrants exploration of alternative tension-free techniques.