title: Preferred mesh-based inguinal hernia repair in a teaching setting: results of a randomized study.
abstract: OBJECTIVE
  Surgeons' preferences for any of 3 methods of inguinal hernia repair are comparable in terms of operating time, incision length, perceived difficulty, and surgeon's satisfaction.
  
  
  METHODS
  Randomized patient-blinded study.
  
  
  METHODS
  Teaching hospital.
  
  
  METHODS
  A total of 334 patients randomized to receive 1 of the 3 repairs.
  
  
  METHODS
  Patients underwent hernia repair with the Prolene Hernia System, mesh plug repair, or Lichtenstein technique.
  
  
  METHODS
  Operating variables, surgeon's rating of satisfaction and difficulty, grade and experience of the operating team, and complications.
  
  
  RESULTS
  The Lichtenstein technique took significantly the longest operating time (52 minutes vs 41 or 42 minutes; P<.001). The mesh plug repair scored the best results in difficulty and satisfaction. Overall, surgeons having performed more than 5 procedures rated the repairs less difficult and with significantly more satisfaction (P<.001 and P = .001, respectively). The complication rate did not differ between the treatment groups. None of the operative findings was correlated to the outcome, except for adverse correlation with the body mass index.
  
  
  CONCLUSIONS
  From a surgeon's point of view, the mesh plug repair is superior to the Lichtenstein technique and the Prolene Hernia System in terms of operating time, incision length, perceived difficulty, and surgeon's satisfaction.
authors.affiliation: Department of Surgery, Canisius-Wilhelmina Hospital, 6500 HBNijmegen, the Netherlands. s.nienhuijs@hccnet.nl
authors.forename: Simon
authors.initials: S
authors.lastname: Nienhuijs
authors.forename: Barbara
authors.initials: B
authors.lastname: Kortmann
authors.forename: Michiel
authors.initials: M
authors.lastname: Boerma
authors.forename: Luc
authors.initials: L
authors.lastname: Strobbe
authors.forename: Camiel
authors.initials: C
authors.lastname: Rosman
mesh_terms: D013505:Digestive System Surgical Procedures / Q000193:education / Q000379:methods; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D016037:Single-Blind Method; D013526:Surgical Mesh