Tension-free inguinal hernia repair comparing shouldice repair with mesh plug repair: A prospective randomized controlled clinical trial

Abstract

Tension-free inguinal hernioplasty is sine-qua-non for a good hernia repair and is aptly fulfilled by both mesh plug repair and a correctly done Shouldice repair. To clarify the effectiveness of Shouldice repair in comparison with mesh plug repair for inguinal hernia. A randomized, bias-free study was conducted on 120 patients with blinding adopted during the computation of results. All 120 patients underwent 120 repairs after being randomized into 2 groups. Sixty repairs were done with plug mesh secured with 2-0 prolene sutures, while the other 60 patients underwent Shouldice repair using 1-0 prolene sutures. Duration of surgery and ergonomics were noted for each case. The operative time was comparable (mean of 38 min for the Shouldice group and 36 min for the mesh group), (P > 0.5; insignificant). Postoperative complications were minimal in both series. Both groups recorded no recurrences till date. However, Shouldice scored better than mesh when cost of the mesh and Shouldice sutures were compared, other factors being similar. Mesh repair is definitely the more popular version of the two but in countries where cost factors still play a part and prevent many from seeking early treatment, a well constructed Shouldice is an equally effective and less costly treatment option for inguinal hernias