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A prospective trial of primary inguinal hernia repair by surgical trainees

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Abstract

The main hypotheses were that the Lichtenstein inguinal hernia repair has a lower recurrence rate and similar incidence of chronic groin pain compared to sutured repairs when performed by surgical trainees. In a U.S. Veterans Administration Hospital, 150 primary hernia repairs were randomized to a Lichtenstein, McVay, or Shouldice repair. The Shouldice repair included a routine relaxing incision. First- and second-year residents, under the supervision of an experienced general surgeon, performed the procedure. Long-term follow-up was obtained in 81% of patients. Hernia recurrence rate was Lichtenstein 8%, McVay 10%, Shouldice 5% (P>0.1) at 6–9 years follow-up. More patients had chronic groin pain following Lichtenstein repair (38%) than after Shouldice repair (7%) (P<0.05). More information is needed on long-term groin pain following anterior mesh repair. The Shouldice inguinal hernia repair may have a role in open primary herniorrhaphy to decrease the risk of chronic groin pain.

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Acknowledgements

The authors thank Sharon Misho for data collection and Pamela McGrath for manuscript preparation.

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  1. B. W. Miedema

    Present address: , One Hospital Drive MC422, Columbia, MO 65212, USA

Authors and Affiliations

  1. Departments of Surgery, Harry S. Truman Veterans Administration Hospital and the University of Missouri Health Center, Columbia, Missouri , USA

    B. W. Miedema, S. M. Ibrahim, B. D. Davis & D. G. Koivunen

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  1. B. W. Miedema
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  2. S. M. Ibrahim
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  3. B. D. Davis
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  4. D. G. Koivunen
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Correspondence to B. W. Miedema.

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Miedema, B.W., Ibrahim, S.M., Davis, B.D. et al. A prospective trial of primary inguinal hernia repair by surgical trainees. Hernia 8, 28–32 (2004). https://doi.org/10.1007/s10029-003-0151-z

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  • DOI: https://doi.org/10.1007/s10029-003-0151-z

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