The Lichtenstein repair in 2002: an overview of causes of recurrence after Lichtenstein tension-free hernioplasty

Abstract.

Lichtenstein tension-free hernioplasty began in 1984. Based on our own mistakes, in the late 1980s, we established a set of key principles and reported the causes of our recurrences. Recently, other authors analyzing the causes of their own recurrences with tension-free repair are drawing the same conclusions. This indicates that others are repeating our previously reported mistakes. To prevent recurrence, the mesh size was increased to 7.5×15 cm to extend well beyond the boundary of the inguinal floor and give the mesh a dome-shaped laxity to compensate for the increased intra-abdominal pressure and mesh shrinkage. Wide extension of the mesh beyond the inguinal floor and the dome-shaped laxity of the mesh served to further reduce recurrence rate. Following the key principles of the Lichtenstein tension-free hernioplasty, which can be facilitated by using a recently developed prosthesis that addresses all the key principles of the procedure, achieves the best result.