Open Hernia Repair

Inguinal hernias are a common clinical condition that is present to the surgical clinic and open inguinal hernias repairs are one of the most common operations that are performed by general surgeons. Open inguinal hernia repairs have evolved from tension repairs like the Bassini and darning repair to the shouldice repair. As these procedures were under tension and hence the recurrence rates were high. The Lichtenstein repair was a tension free repair that uses mesh, revolutionized hernia repair as the procedure was simple and the recurrence rates were low whether the procedure was performed by a junior or senior surgeon. The Lichtenstein repair is now the most popular repair for inguinal hernias. Variants to this include the plug and patch repair and the prolene hernia system, which uses various types of tension free mesh repairs. This chapter investigates the various open hernia techniques with emphasis on the tension free repairs which involve the use of mesh (Lichtenstein) and not the use of mesh (Desarda). The older tension repairs like the Shouldice and Bassini repairs are also reviewed.