The Journal of Bucharest College of Physicians and the Romanian Academy of Medical Sciences

Existing Controversies in Inguinal Hernia Treatment


Inguinal hernia is one of the most frequently encountered adult pathologies requiring surgical treatment, and it represents an important problem for healthcare systems, with multiple consequences on both the social and economic plan. Although its incidence and prevalence are not exactly known, the admitted possibility for an individual to get an inguinal hernia during his lifetime ranges around 27% for men compared to only 3% for women. [1] [2]. The evolution of surgery has brought to the fore multiple technical developments which, although technically alluring, could not manage to become surgical standard procedures. The 80’s saw the development of synthetic alloplastic materials and also “tension-free” repair principles, peaking with the Lichtenstein technique, which decreased the relapse rate so much that it made this procedure the “gold standard” of this type of pathology for many surgeons. The development of minimal invasive surgery gradually overtook all abdominal “organs” and the early nineties, starting with 1993, saw the rapid development of minimal invasive techniques for the treatment of inguinal hernia, which proved to be statistically as efficient as the technique Lichtenstein initially described. From that moment on, the surgical world adopted radically different positions, each surgical school offering arguments for or against classical or laparoscopy methods, a dispute which triggered many controversies, more or less backed by statistical data.