A Simple Method to Avoid Recurrence in Licthenstein Free Hernioplasty in Huge, Longstanding Inguinoscrotal Hernia

Inguinal hernia (I.H) repair is one of the commonest surgical procedures and is an important training operation for youngs as it combines a low mortality risk and appropriate technical challenge. The optimum method for I.H. repair has not yet been determined. The recurrence rates for non mesh sture repair of I.H. vary between 0.2-33%, but licthenstein free hernioplasty (L.F.H.) has a world wide reported recurrence rate of 1%. The present study tried to compare the results of L.F. mesh onlay hernioplasty alone and the above method plus narrowing of U shaped internal inguinal ring to admit the tip of the little finger only by plication of the fascia transversalis as a separate step in huge, long standing inguinoscrotal hernia. There was no recurrence by adding this step compared by 3 cases of recurrences (16.6%) in control group. Adding U/S examination to the groin led to discovery of recurrence in two cases with groin pain but without bulge on straining.