Internal Ring Occlusion and Floor Support: A Novel Technique for Inguinal Hernia Mesh Repair

Abstract

Tension-free, open-mesh, inguinal herniorrhaphies have gained wide acceptance. Current mesh techniques reinforcing the internal ring do not provide a comfortable lay to the mesh. To address this, we used the internal ring occlusion and floor support (IROFS) technique. A retrospective review was undertaken of all hernias operated on with the IROFS technique from January 2001 to December 2006. Five hundred twenty-five inguinal hernia repairs were done in 477 male patients. Telephone questionnaires looking into their postoperative course and recurrence were recorded. We contacted 275 (58%) patients. Patients' ages ranged from 29 to 81 years (mean, 57 years). The hernia was indirect in 50 per cent (n=146), direct in 35 per cent (n=102), or both in 15 per cent (n=44) of patients. The average operative time was 40 minutes. Acute wound pain lasted for less than 1 week in 55 per cent (n=151) and for 1 to 2 weeks in 24 per cent (n=66). Postoperative analgesic requirement was less than 1 week in 54 per cent (n=147) and 1 to 2 weeks in 27 per cent (n=74). Most patients returned to their daily activities in 2 weeks (75%) and to work in 3 weeks (74%). Chronic pain lasted for 6 to 48 months (mean, 20 months) in only seven patients. No recurrence of hernia was observed during follow-up visits (range, 26-96 months; mean, 53 months). In conclusion, IROFS can be performed with little difficulty, is cost-effective, and is well tolerated by the patient.