A study about inguinal hernia mesh repairs:plug and patch versus lichtenstein mesh repair technique


  • Rana Ranjit Singh Department of Surgery,SGRDIMSR,Amritsar, India
  • Arun Kumar Gupta Department of Surgery,SGRDIMSR,Amritsar, India
  • Avreen Singh Shah Department of Surgery,SGRDIMSR,Amritsar, India
  • Rupinderjit Singh Department of Surgery,SGRDIMSR,Amritsar, India
  • Angadjot Singh Department of Surgery,SGRDIMSR,Amritsar, India




Inguinal hernia, Lichtenstein, Mesh repair, Plug and patch


Background: The study was conducted on 200 patients admitted with inguinal hernias, at Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India.

Methods: This study was conducted on the simple technique of mesh repair in inguinal hernia patients of type 1,2, and 3, according to Gilbert’s classification of groin hernias, in the form of randomized controlled trial of plug and patch versus Lichtenstein mesh repair technique in a group of randomly selected 100 cases of inguinal hernias each in relation to concurrent study of operating time, any intraoperative or postoperative  complications, post-operative pain, length of hospital stay, recurrence rate and time taken to return to normal routine activities and work, under the regular follow up intervals of 1 week, 3 weeks and 6 month.

Results: Most common in 4th decade especially in patients doing strenuous activity. Right indirect hernia was most common and between both the groups it was seen that post-operative stay was similar.

Conclusions: Both the techniques, lichtenstein and plug and patch inguinal hernia repair, are equally good in terms of negligible intra-operative, post-operative complications and overall outcome with good patient compliance and satisfaction.


Mcvay CB. Inguinal and femoral hernioplasty. Arch Surg. 1948;57:524-30.

Zimmerman LM. Surgical management of direct inguinal hernia. Surg Gynae Obst. 1938;6:193.

Bassini E. Nuovo metodo per la cura radical dell’ernia inguinale. Atti Congr Associ Med Ital. 1887;2:179-81.

Bassini, E. Sulla cura radical dell’ernia inguinale. Arch Soc Ital Chir. 1887;4:380-88.

Bassini, E. Uber de behandlung des leistenbruches. Arch Klin Chir. 1890;40:429-76.

Mcvay CB. Inguinal hernioplasty: anatomic repair. Arch Surg. 1940;77:213-25.

Shearburn EW, Myers RN. Should ice repair for inguinal hernia. Surgery. 1969;66:450-9.

Stoppa R, Watlaumont CH, Verhaeghe P, Henry X. Tulle de dacron et cure chirurgicale des hernies de I'aine. Chirurgie. 1983;109:847-54.

Lichtenstein IL, Shulman AG, Amid PK, Montllor MM. The tension-free hernioplasty. Am J Surg. 1989;157:188-93.

Rutkow IM, Robbins AW. Tension-free inguinal herniorrhaphy: a preliminary report on the "mesh plug" technique. Surgery. 1993;114:3-8.

Mckernan JB, Laws HL. Laparoscopic repair of inguinal hernia using a totally extraperitoneal prosthetic approach. Surg Endosc. 1993;7:26-8.

Lichtenstein IL, Shore JM. Simplified repair of femoral and recurrent inguinal hernias by a plug technique. Am J Surg. 1974;128:439-40.

Gilbert AI. Sutureless repair of inguinal hernia. Am J Surg. 1992;163:331-5.

Robbins AW, Rutkow IM. The mesh-plug hernioplasty. Surg Clin North Am. 1993;73:501-12.

Rutkow IM, Robbins AW. 1669 Mesh plug hernioplasties. Contemp Surg. 1993;43:141-7.

Robbins AW, Rutkow IM. Mesh plug repair and groin hernia surgery. Surg Clin North Am. 1998;78:1007-23.

Kang SK, Burnett CA, Freund E, Sestito J. Hernia: is it a work-related condition? Am J Ind Med. 1999;36(6):638-44.

Katz DA. Evaluation and management of inguinal and umbilical hernias. Pediatr Ann. 2001;30(12):729-35.

Saad A, Gaber M, Metawe A, Fathy M. J Med Research Ist. 2010;31:24-30.

Milic DJ, Pejic MA. Tension-free procedures in the treatment of groin hernias. Srpski Arhiv Za Celokupno Lekarstvo. 2003;131(1-2):82-91.

Usher FC, Hill J, Ochsner J. Hernia repair with surgery. 1959;46:718-20.

Stoppa RE, Rives JL. The use of dacron in groin hernia repair. Surg Clin North Am. 1984;64:269.

Gilbert AI, Young J, Graham MF. Combined anterior and posterior inguinal hernia repair. Intermediate recurrence rates with three groups of surgeons. Hernia J Surg. 2004;8:203-7.

Lippincott Williams and Wilkins. Repair of Groin Hernia with Synthetic Mesh. Ann Surg. 2002;235(3):322-32.

Ahmad S. Conservative management of mesh site infection. J Ayub Med Coll Abbottabad. 2007;19(4):75-7.

Amid PK, Shulman AG, Lichtenstein IL. Open tension-free repair of inguinal hernias: the Lichtenstein technique. Eur J Surg. 1996;162(6):447-53.

Baracs J, Huszár O, Gadácsi M, Horváth OP, Wéber G. Long-term results of open tension-free or tension repair of inguinal hernias-retrospective study. Magy Seb. 2010;63(5):297-301.

Rutkow IM, Robbins AW. Tension-free inguinal herniorrhaphy: a preliminary report on the mesh plug technique. Surgery. 1993;114(1):3-8.

Pierides G, Vironen J. A prospective randomized clinical trial comparing the prolene hernia system® and the lichtenstein patch technique for inguinal hernia repair in long term: 2- and 5-year results. Am J Surg. 2011;202(2):188-93.

Benizri EI. Open inguinal hernia repair by plug and patch: the value of fibrin sealant fixation. Hernia. 2006;10(5):389-94.

Bringman s. Tension-free inguinal hernia repair: tep versus mesh-plug versus lichtenstein. Ann Surg. 2003;237(1):142-7.

Millikan KW, Cummings B, Doolas A. The Millikan modified mesh-plug hernioplasty. Arch Surg. 2003;138(5):525-9.

Fei L, Filippone G, Trapani V, Cecchi M, Cuttitta D. New devices for inguinal hernia repair in elderly patients. Acta Biomed. 2005;76(1):33-6.

Jürgen Z, Beatrix H, Frank A. Inguinal hernia repair in the new millennium: plug and patch repair with local anaesthesia. World J Surg. 2001;25:138-41.

Kark AE, Kurzer MN, Belsham PA. Three thousand one hundred seventy five primary inguinal hernia repairs: advantages of ambulatory open mesh repair using local anaesthesia. J Am Col Surg. 1998;186:447-56.

Fasih T, Mahapatra TK, Waddington RT. Early results of inguinal hernia repair by the mesh plug technique- first 200 cases. Ann R Coll Surg Engl. 2000;82:396-400.

Gianetta E, Cuneo S, Vitale B, Camerini G, Stella M. Anterior tension free repair of recurrent inguinal hernia under local anaesthesia. Ann Surg. 2000;231:132-6.

Tarek I, Ayman A. Talaat MD. Comparative study in the form of plug and patch versus lichtenstein hernioplasty in recurrent inguinal hernias. Egyptian J Surgery. 2003;22(1):44-5.

Klaristenfeld DD. Minimally invasive tension free inguinal hernia repair. Surg Technol Int. 2005;14:157-63.






Original Research Articles