The 'plug' repair of 1402 recurrent inguinal hernias. 20-year experience

A. G. Shulman, P. K. Amid and I. L. Lichtenstein
Department of Surgery, Cedars-Sinai Medical Center, Century City Hospital, Los Angeles, Calif.

Since 1968, we have treated virtually all recurrent inguinal hernias by suturing a polypropylene mesh plug into the defect. Treatment of recurrent inguinal hernias by the usual standard methods results in a high rate of failure. This is due to reapproximation under tension of already scarred tissues. The plug is designed to occlude the hernial defect without tension. Several improvements in technique based on extensive experience with this method have been developed. Such repairs result in minimal postoperative discomfort and rapid rehabilitation. This report is based on 1402 operations, with a follow-up of 91% of the patients. There were 1276 patients who were followed up for 3 to 21 years and the recurrence rate was 1.6%. The plug repair for most recurrent inguinal hernias is recommended.