[Skip to Content]
Sign In
Individual Sign In
Create an Account
Institutional Sign In
OpenAthens Shibboleth
[Skip to Content Landing]
September 1993

Preperitoneal Prosthetic HerniorrhaphyOne Surgeon's Successful Technique

Author Affiliations

From the Swedish Hospital Medical Center, Seattle, Wash.

Arch Surg. 1993;128(9):964-970. doi:10.1001/archsurg.1993.01420210024003

Objectives:  To review the senior author's experience with preperitoneal mesh inguinal herniorrhaphy, evaluate the recurrence rate, and compare it with previously published data and with the developing technique of laparoscopic herniorrhaphy.

Design:  A retrospective records review of 204 herniorrhaphies, follow-up of patients (mean follow-up, 3.5 years), and review of the literature.

Setting:  One general surgeon's clinical practice in an 860-bed regional referral hospital.

Patients:  One hundred sixty-two men and 13 women (mean age, 63 years) who underwent preperitoneal prosthetic herniorrhaphy by the senior author between 1984 and 1991 and whose medical records were available for review (175 [96%] of 183 patients).

Main Outcome Measures:  Short- and long-term postoperative complications and hernia recurrence.

Results:  One hundred fifty-two primary and 52 recurrent inguinal hernias were repaired using a preperitoneal prosthetic approach and either general or regional anesthesia. Wound complications occurred in 12 (5.9%) of 204 operations, and one recurrence (0.5%) was detected over the mean long-term follow-up period of 42 months (range, 7.9 to 110 months). A 25-year recurrence rate of 1% was predicted.

Conclusions:  This repair compares favorably with similar, previously reported repairs and is suggested as a standard for comparison with the developing technique of laparoscopic herniorrhaphy.(Arch Surg. 1993;128:964-970)

Read RC.  Preperitoneal herniorrhaphy: a historical review . World J Surg . 1989; 13:532-540.Article
McKernan JB, Laws HL.  Laparoscopic preperitoneal prosthetic repair of inguinal hernias . Surg Rounds . (July) 1992:597-607.
Read RC.  Preperitoneal prosthetic inguinal herniorrhaphy without a relaxing incision . Am J Surg . 1976;132:749-752.Article
Rignault DP.  Properitoneal prosthetic inguinal hernioplasty through a pfannenstiel approach . Surg Gynecol Obstet . 1986;163:465-468.
Greenburg AG.  Revisiting the recurrent groin hernia . Am J Surg . 1987;154: 35-38.Article
Nyhus LM, Pollack MB, Bombeck CT, Donahue PE.  The preperitoneal approach and prosthetic buttress repair for recurrent hernia . Ann Surg . 1988;208:733-737.Article
Halverson K, McVay CB.  Inguinal and femoral hernioplasty . Arch Surg . 1970; 101:127-135.Article
Ijzermans JNM, de Wilt H, Hop WCJ, Jeekel H.  Recurrent inguinal hernia treated by classical hernioplasty . Arch Surg . 1991;126:1097-1100.Article
Nyhus LM, Klein MS, Rogers FB.  Inguinal hernia . Curr Prob Surg . 1991;28: 401-450.Article
Read RC.  Recurrence after preperitoneal herniorrhaphy in the adult . Arch Surg . 1975;110:666-671.Article
Regier H.  Laparoscopic hernia repair . Laparosc Focus . 1992;1:No. (1) . 1.
Ferzli GS, Massad A, Albert P.  Extraperitoneal endoscopic inguinal hernia repair . J Laparoendosc Surg . 1992;2:281-286.Article
George SM, Mangiante EC, Voeller GR, Britt LG.  Preperitoneal herniorrhaphy for the acutely incarcerated groin hernia . Am Surg . 1991;57:139-141.
Lichtenstein IL. Hernia Repair Without Disability . 2nd ed. Tokyo, Japan: Ishiyaku Euroamerica Inc; 1986.
Lichtenstein IL, Amid PK, Shulman AG.  The iliopubic tract: is it important in groin herniorrhaphy? Contemp Surg . 1992;40:22-24.
Miller I.  An update: laparoscopic herniorrhaphy . Laparosc Focus . 1992;1:No. (8) .