The mesh plug technique for recurrent groin herniorrhaphy: A nine-year experience of 407 repairs

Abstract

Background: Recurrent inguinal hernias can be repaired efficaciously by mesh plug techniques, which have had better results than traditional tissue-based repairs in several small studies. This report provides a detailed description and assessment of the anterior, tension-free, “umbrella” mesh plug method for recurrent groin herniorrhaphy. Methods: We performed a retrospective analysis of 407 patients with recurrent inguinal and femoral hernias treated with an umbrella mesh plug repair since 1989. Information was recorded about postoperative recovery and complications, and patients were examined for rerecurrences 1 week after operation and annually thereafter. Results: Of the 320 patients with a first-time recurrence, 6 (2%) had a rerecurrence after placement of a mesh plug. Of the 87 patients who had undergone 2 or more prior repairs, 8 (9%) had a rerecurrence subsequent to a mesh plug hernioplasty. Nine (64%) of the 14 rerecurrences were noted within 1 year of operation; 4 (29%) were found 2 years after operation and 1 (7%) during postoperative year 3. During the 9 years of follow-up study, a mesh plug has not been involved in any infectious process requiring removal. There have been no instances of draining sinus tracts, ischemic orchitis, long-term pain, vascular and embolic phenomena, or plug erosion and migration. Two hundred fifteen (53%) of the patients took no pain medication. One hundred fifty-nine patients (39%) used nothing more than nonprescription pain medicine. Three hundred seventy-five patients (92%) returned to normal daily activities within 4 days of the herniorrhaphy. Conclusions: Patients with recurrent groin hernias, who undergo a minimal-dissection umbrella mesh plug repair, have a rapid recovery and few postoperative complications. (Surgery 1998;124:844-7.)