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In principle, all of the repair methods that are currently available may be offered to you. However, not every inguinal hernia operation is suitable for every patient.
Given the very varied intra-operative findings that can occur in terms of the hernia type and tissue characteristics, the surgical technique is tailored to the patient's individual requirements.
This is known as "tailored surgery". What matters most is that the individual properties of the tissue involved and the nature of the hernia are taken fully into account when determining the choice of surgical procedure.
Wherever possible, every attempt is made to operate without a mesh implantation (avoidance of foreign body material). At our facility, the proportion of mesh-free operations is 60-70%.
Mesh-free Operations
1. Minimal inguinal hernia repair surgery (Muschaweck repair)
This method was introduced in 2002 by Dr. Ulrike Muschaweck and has since gained global acceptance for the surgical repair of sports hernias.
It can also be applied for small inguinal hernias. The principle behind it involves making no incisions into intact structures and instead only "repairing" the actual defect. A tension-free suturing technique means that pain after the operation is significantly less, and the muscles required for unrestricted movement remain fully intact. With this method, patients can return to sport after just 2-3 days without any increased risk of a further inguinal hernia.2. Shouldice method<br />(inguinal hernia surgery)
In patients whose indirect and direct hernias do not exceed a certain size, the Canadian method developed by Dr. E. Shouldice (tailored surgery) is used.
The hernial orifice is closed using a fascia displacement technique, which is a type of suturing technique. The key point here is that the posterior wall of the inguinal canal needed for the suturing technique required for the suturing technique is sufficiently strong to allow the suturing procedure to take place.3. Desarda technique
In patients with a medial hernia in which a classic suturing method does not appear to be sufficient, this more recent method developed by the Indian surgeon Mohan P. Desarda, which uses the body's own tissue (the lower section of the external fascia) to reinforce the posterior wall, can be used. If the fascia displacement flap has the right physical characteristics, this technique can achieve similar results to surgery without the use of synthetic meshes.
Mesh Implantation
1. Lichtenstein method
In patients with a weak abdominal wall and large hernial orifices (direct hernias, direct inguinal hernia), the Lichtenstein method can be used. This is a tension-free method involving the implantation of a mesh. This surgical method has also been proven to be effective for recurrent hernias (repeat herniation). This procedure, first described by Irving Lichtenstein, was introduced in 1985 and is the world's most commonly performed open mesh procedure.
2. TIPP method (trans-inguinal pre-peritoneal-plasty)
This method is based on the surgical technique developed by Dr. Rives. In this case, a large mesh is positioned below the abdominal wall fascia between the abdominal wall and the peritoneum (pre-peritoneal). This procedure is suitable for patients with complex hernias, combined hernias and recurrent hernias.3. Laparoscopic method
In view of the specific problems that are associated with them (general anaesthesia, possibility of serious complications, inevitable mesh implantation, inpatient admission), laparoscopic methods are reserved exclusively for special cases (such as multiple recurrences) and are subject to strict indication criteria.
