Abstract
A new procedure for inguinal hernia is described: the Thovara method. This technique is really a modified version of Lichtenstein's tension-free hernioplasty to which is added a Kirschner-like transposition of the spermatic cord. Between 1988 and 1992, 654 Thovara hernioplasties were performed. 95% (621) patients underwent physical examination one year after the operation and 511 (78%) were reexamined five years after surgery. Early recurrences (< 1 year) were noted in five cases (0.8%). In three cases the mesh had to be removed because of infection. In late follow-up (5 years) no recurrences were observed but in five cases (1%) testicular atrophy was present. The Thovara method is a simple and physiological repair, which eliminates recurrence, the “bete noire” of inguinal herniorrhaphies. However, almost one half of recurrences are discovered five to ten years after the operation and final evaluation of this technique must await randomized controlled trials and comparisons with alternatives.
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