The ONSTEP inguinal hernia repair technique: initial clinical experience of 693 patients, in two institutions
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Experience with a novel hernioplasty procedure—the ONSTEP approach—for inguinal hernia repair in a large series of patients performed by two surgeons at two institutions is described, focusing in particular on the duration of surgery, the time taken to return to normal activities, chronic pain, complication and recurrence rates.
Adult patients underwent inguinal hernia repair using the ONSTEP approach. The hernia defect was repaired using a PolySoft™ hernia patch. Patients were followed up for 1 year for pain, complications and recurrences.
A total of 693 patients underwent ONSTEP inguinal hernia repair. The mean duration of surgery (±SD) was 17 ± 6 min; the time to discharge from hospital was less than 24 h in all patients; and the mean time to return to normal daily activities was 6.1 ± 3.0 days. The overall complication rate was 1.0 % and the overall recurrence rate was 0.6 %. Residual pain was present in 4 patients at 6 months and was cured by removal of the memory ring in 3 patients and disappeared spontaneously in one case, so that there was no case of chronic pain at 1 year.
The ONSTEP inguinal hernia repair technique described is simple, quick to perform, produces consistent results and is associated with very low overall complication, chronic pain and recurrence rates. It may offer an alternative to both Lichtenstein and laparoscopic inguinal hernia repair.
KeywordsInguinal hernia repair Open hernia repair ONSTEP hernia repair Chronic pain Recurrence Complications
The authors would like to acknowledge Ignis Vitae Ltd. for writing assistance and Ivan Freud for illustrations of the ONSTEP technique, supported by a grant from CR Bard.
Conflict of interest
- 1.National Institute for Clinical Excellence (2004) Laparoscopic surgery for inguinal hernia repair. Technology Appraisal 83. Available at: www.nice.org.uk/nicemedia/live/11542/32924/32924.pdf
- 14.Eklund A, Carlsson P, Rosenblad A, Montgomery A, Bergkvist L, Rudberg C, Swedish Multicentre Trial of Inguinal Hernia Repair by Laparoscopy (SMIL) study group (2010) Long-term cost-minimization analysis comparing laparoscopic with open (Lichtenstein) inguinal hernia repair. Br J Surg 97(5):765–771PubMedCrossRefGoogle Scholar
- 15.Ferzli G, Masaad A, Albert P, Worth MH (1993) Endoscopic extraperitoneal herniorrhaphy versus conventional hernia repair. A comparative study. Curr Surg 50:291–294Google Scholar
- 18.O A, A G, M J, H WC, Al-Kandari A, S C, M M (2011) Is laparoscopic inguinal hernia repair more effective than open repair? J Coll Physicians Surg Pak 21(5):291–296Google Scholar