Mini-Hernia: Inguinal Hernia Repair through a 2-cm Incision.
Nduka CC, Darzi A. Surg Technol Int. 1995;IV:165-7.
The optimal management of inguinal hernia continues to excite lively debate and, despite centuries of research, the ideal approach has yet to be established. The traditional repairs of McVay, Bassini, and Shouldice involve suturing together tissues that are not normally in apposition. This approximation of tissues under tension may account for the reported recurrence rates of up to 21% for primary repairs and also explain the lengthy, painful recovery periods. Laparoscopic hernia repair has demonstrated good short-term results but is technically demanding, requires violation of the peritoneal cavity, and has unknown long-term results. Between October 1993 and April 1995, we performed 103 hernia repairs using a novel approach, the mini-hernia repair (endoscopically guided surface repair of inguinal hernia). This technique allows the benefits of an open surgical approach such as hands-on manipulation, three-dimensional vision, a familiar anatomical approach, and the use of conventional instruments, to be combined with the advantages derived from the use of laparoscopic instrumentation, namely, minimized tissue trauma and improved cosmesis.