Current treatment concepts for groin hernia.
OBJECTIVE
The purpose of this study is to review the latest evidence on operative and perioperative management of patients with groin hernia.


METHODS
A literature review of medical databases was undertaken. Recent scientific evidence provided by quality reports was selected and discussed critically.


RESULTS
The Shouldice repair results in low recurrence rates compared to other tissue reconstructions. However, mesh repairs are superior to tissue reconstruction in terms of recurrence. Lichtenstein's technique remains the gold standard, with low incidence of hernia recurrence and minimal morbidity. Endoscopic techniques have been popularized during the past decades, as alternative approaches to open surgery. Both transabdominal preperitoneal repair (TAPP) and the totally extraperitoneal repair (TEP) are effective in the treatment of groin hernia, although the steep learning curve precludes popularization and may account for increased perioperative morbidity.


CONCLUSIONS
Groin hernia surgery remains an evolving field of investigation. Mesh application remains the mainstay of durable results. Individual patient factors and hernia characteristics need to be taken into account when considering the most appropriate surgical practice.
Center for Minimally Invasive Surgery, Neuwerk Hospital, Mönchengladbach, Germany, stavros.antoniou@hotmail.com.
Stavros A
SA
Antoniou
Rudolph
R
Pointner
Frank A
FA
Granderath
D000368:Aged; D006119:Groin / Q000503:physiopathology / Q000601:surgery; D006552:Hernia, Inguinal / Q000175:diagnosis / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000503:physiopathology; D019990:Perioperative Care / Q000379:methods; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D013526:Surgical Mesh; D013718:Tensile Strength; D016896:Treatment Outcome