Morfesis's thoughtful response appears to affirm my editorial contention that the manner in which herniorrhaphies are currently evaluated needs updating. I find it inconceivable that recurrence rates are regarded as the sine qua non of an effective hernia operation when other outcome measures (ie, technical difficulty, complication rate, rehabilitation status, and socioeconomic factors) also would seem relevant. Regarding some of his specific questions: my use of the Marlex mesh PerFix (CR Bard, Davol Division, Cranston, RI) plug hernioplasty in almost 3000 patients has, indeed, never resulted in an infection necessitating removal of the prosthesis or rendered "the person unable to work for years at a time."1,2 The concept of minimal dissection, tension-free repair, shortened operating time, and the fact that Marlex mesh is a macroporous biomaterial that does not promote or harbor infection have been the major reasons for such excellent results. I would disagree about "our"
Rutkow IM. The Reccurrence Rate in Hernia Surgery-Reply. Arch Surg. 1996;131(1):107–108. doi:10.1001/archsurg.1996.01430130109027
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