Feasibility of tension-free repair of inguinal hernia in senile patients under ultrasound-guided local nerve block.

The clinical characteristics of open hernia repair under local nerve block guided by ultrasound and epidural anesthesia under daytime surgery mode were compared and analyzed, and the safety, rationality and effectiveness of tension-free repair of inguinal hernia in elderly patients under local nerve block guided by ultrasound were discussed. The clinical data of 200 patients who underwent inguinal hernia day surgery in Liaocheng People's Hospital Affiliated to Shandong First Medical University from January 2022 to October 2022 were retrospectively analyzed, including 150 patients who underwent local anesthesia block surgery and 50 patients who underwent epidural surgery. The visual analog score of the ultrasound local anesthesia group was lower than that of the epidural surgery group at 4 h after operation. The time of getting out of bed and postoperative exhaust were shorter than those of epidural operation group. The recovery rate of unrestricted activity 2 weeks after surgery was higher than that in epidural surgery group (P < 0.05). The incidence of postoperative acute urinary retention between the two groups was lower in local ultrasound anesthesia group, and the difference was statistically significant (P < 0.05). The median follow-up time was 4(1-6) months, and the follow-up rate was 100%. Postoperative complications were seroma, wound infection, chronic pain and recurrence, and there was no statistical significance between the two groups (P > 0.05). No serious complications occurred in both groups. Compared with open epidural surgery, ultrasound-guided local nerve block tension-free day surgery in the elderly has the advantages of less pain, faster recovery, and is safe and feasible.

Feasibility and outcomes of Desarda vs Lichtenstein hernioplasty by local anesthesia for inguinal hernia: a noninferiority randomized clinical trial.

INTRODUCTION: The Desarda autologous tissue repair is comparable to the Lichtenstein hernioplasty for inguinal hernia regarding recurrence, chronic groin pain, and return to work activities. This study was designed to establish the outcomes of Desarda's repair versus Lichtenstein's hernioplasty concerning post-operative recovery to normal gait and its feasibility under local anesthesia (LA). MATERIALS AND METHODS: This study was a single-center, prospective, double-blinded, non-inferiority, randomized trial. Patients undergoing open hernia repair for primary inguinal hernia were included. Patients were randomly assigned and followed up for 2 years. The primary endpoint was the time to return to normal gait post-surgery with comfort (non-inferiority margin fixed as 0.5 days). The secondary outcomes studied were post-operative pain score, the time required to return to work (all previously performed activities), and surgical-site occurrences (SSO). RESULTS: One hundred ten eligible patients were randomly assigned [56 patients (50.9%) in the Desarda group and 54 patients (49.1%) in the Lichtenstein group]. All the procedures were safely performed under LA. The median (interquartile range) time for resuming gait post-surgery with comfort was 5 days in the Desarda vs 4 days in Lichtenstein's arm (P = 0.16), thereby failing to demonstrate non-inferiority of Desarda against Lichtenstein hernioplasty. However, there were no significant differences in days to return to work, SSO, chronic groin pain, and recurrence within two years of surgery. CONCLUSIONS AND RELEVANCE: This study could not demonstrate the non-inferiority of the Desarda repair versus Lichtenstein hernioplasty regarding the time taken to return to normal gait. Comparing the days to return to work, pain score, SSO, and chronic groin pain, including recurrence rate, Desarda repair faired equally with Lichtenstein hernioplasty, thereby highlighting its feasibility and efficacy under LA. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03512366.

Giant inguinal hernia repair using standard transverse inguinal incision with mesh. A retrospective case control study.

BACKGROUND: Giant inguinal hernia (GIH) is a rare condition in the developed world, and the literature is scarce. Case reports describe different techniques in an attempt to prevent abdominal compartment syndrome (ACS). We aimed to review our experience with GIH repair. METHOD: A retrospective review of the medical records of all consecutive patients who underwent a tension-free mesh GIH repair using a transverse inguinal incision between 2014 and 2021 at a tertiary university referral center. In brief, the technique included head-down positioning, maximal pre-incision reduction of hernia contents, and repair with mesh. Follow-up was conducted in outpatient clinic. We compared the results to a time-based open standard inguinal hernia repair group (control group). RESULTS: During the study period, 58 patients underwent an open GIH repair with mesh without abdominal preparation. 232 patients were included in the control group. The mean surgery duration was 125.5 min in the GIH group and 84 min in the control group (p < 0.001). Bowel resection was not necessary in any case. In-hospital complication rates were 13.8% vs. 5.6% in the GIH and control groups, respectively (p = 0.045). Early complication rates (up to 30 days post-operatively) were 62.1% vs. 14.7% in the GIH and control groups, respectively (p < 0.001). Late complications rate was similar (p = 0.476). ACS and mortality were not reported. No recurrence event was reported in the GIH group. CONCLUSION: Tension-free mesh repair for GIH using a standard transverse inguinal incision is feasible and safe and there is no need for abdominal cavity preparation. Early complications are more common than in the control group, but there were no higher rate of late or severe complications and no recurrence event.

A randomised controlled trial of Lichtenstein repair with Desarda repair in the management of inguinal hernias.

BACKGROUND: Ever since the advent of mesh hernioplasty with low recurrence rates, surgeons have turned a blind eye towards its devastating mesh related complications. Consequently, the quest for the best hernia surgery, that is as effective as the mesh repair but lacks its complications, continues. OBJECTIVES: The present study was carried out to compare the results of the Lichtenstein repair with the Desarda repair in the treatment of inguinal hernias. METHODS: A total of 77 patients with 87 hernias were randomly allocated into two groups to undergo either the Desarda repair (Group I, 39 patients with 45 hernias) or the Lichtenstein repair (Group II, Control, 38 patients with 42 hernias). 3 patients didn't complete the follow-up and were excluded from analysis. Finally, 40 hernias were analyzed in the Lichtenstein group and 44 in the Desarda group. RESULTS: After a 6-month follow-up period it was found that neither of the two groups had any recurrence. The incidence of chronic inguinodynia was much higher in the Lichtenstein group as compared to Desarda group. The pain scores, mean operating time, mean time to return to work and analgesic requirement was much lower with the Desarda repair as compared to Lichtenstein repair. CONCLUSION: Desarda repair was found to be as effective as the Lichtenstein repair in terms of recurrence and better in terms of chronic inguinodynia, complications and post operative pain scores. Desarda repair requires a significantly shorter operating time. The economic burden of this repair is much less compared to mesh repair.

Preoperative progressive pneumoperitoneum: The answer for treating giant inguinal hernias while avoiding morbidities?

PURPOSE: Preoperative progressive pneumoperitoneum (PPP) is mostly used for giant abdominal incisional hernias, and only a few isolated or paired cases that used PPP in the treatment of giant inguinal hernias (GIH) have been reported. The main objective of this study is to describe our technique in the use of PPP in the treatment of GIH in a series of patients who presented with this challenging condition. METHODS: We retrospectively reviewed the medical records of a series of patients treated with PPP for GIH during a 6-year period (2012-2018) at a single institution. The demographics, preoperative, and surgical characteristics were analyzed. RESULTS: In total, 7 patients were treated for GIH with PPP. The median age was 64 (range 30-89) years. The median history time with the inguinal hernia was 8 (range 2-20) years. The median time of PPP was 22 (range 15-30) days. All patients underwent the Lichtenstein technique. The median follow-up time was 12 (range 3-84) months. Three (42.8%) of the patients had preoperative complications. Two patients developed mild dyspnea during PPP, and another patient had subcutaneous emphysema during the insertion of the catheter. Two (28.5%) patients had postoperative complications. One of them developed a right scrotal abscess, and another patient developed bilateral grade III hydrocele. CONCLUSION: With our limited experience, it is too early to tell if this should be the gold standard for the treatment of GIH. To see if there is superiority among different procedures, more studies that compare the morbidity of PPP with that of other trans operative techniques are needed. Nevertheless, the procedure we propose has provided satisfactory results.

Open tensionless repair techniques for inguinal hernia: a meta-analysis of randomized controlled trials.

BACKGROUND: Lichtenstein repair (LR), mesh-plug repair (MPR), and prolene hernia system (PHS) are three common open tensionless repair techniques for inguinal hernia (IH); each technique has its supporters and controversies never stop. It is necessary to perform a meta-analysis to evaluate the clinical efficacy of these three open tensionless repair techniques. METHODS: RCTs comparing at least any two of the three open tensionless repair techniques for IH were searched in online databases. Literature screening and quality assessment were carried out basing on the established inclusion criteria and exclusion criteria. Statistical analyses were carried out using RevMan software 5.3. The primary outcomes were recurrence, chronic pain and time to return to work. Secondary outcomes were inguinal paresthesia, testicular and scrotal problems, hematoma, seroma and wound infection. RESULTS: Twenty-two references on fifteen RCTs involving a total of 3716 hernias were selected for the meta-analysis. In these trials, seven comparing LR and MPR, five comparing LR and PHS, and three comparing LR, MPR and PHS. All primary and secondary outcomes could be pooled analyzed in comparison of MPR and PHS with LR, while only two primary outcomes (recurrence and chronic pain) and one secondary outcome (wound infection) could be pooled analyzed in comparison of MPR with PHS. Results of this meta-analysis demonstrated that MPR and PHS were comparable to LR in all primary and secondary outcomes, and MPR and PHS were comparable in terms of recurrence, chronic pain and wound infection. CONCLUSIONS: This meta-analysis indicates that MPR and PHS seem comparable to LR in terms of recurrence, chronic pain, time to return to work, inguinal paresthesia, testicular and scrotal problems, hematoma, seroma and wound infection. MPR and PHS seem comparable in terms of recurrence, chronic pain and wound infection.

Common Tenets in Repair of Primary Paraesophageal Hernias: Reducing Tension and Maximizing Length.

Tension-free repair remains the most important principle of surgical management of giant paraesophageal hernias. The axial tension is relieved by generous circumferential mobilization of the esophagus in the mediastinum to the level of subcarina. An esophageal lengthening procedure may be necessary for a true short esophagus. The radial tension is managed by mobilizing the left and right diaphragmatic crus. Adjunctive procedures such as pleurotomy or diaphragmatic relaxation incisions may be needed to further reduce the tension on the repair.

Midline preperitoneal repair for incarcerated and strangulated femoral hernia.

OBJECTIVE: Femoral hernias constantly present as incarceration or strangulation and require emergency surgery. Incarcerated and strangulated femoral hernia repair remains challenging and controversial. The aim of our study was to analyze the efficacy of preperitoneal tension-free hernioplasty via lower abdominal midline incision for incarcerated and strangulated femoral hernia. METHODS: Data of 47 patients who underwent emergency surgery for incarcerated or strangulated femoral hernias from January 2009 to December 2017 were retrospectively analyzed. According to the surgical incisions, they were divided into two groups: the observation group (21 cases) had a lower abdominal midline incision, and the control group (26 cases) had a traditional inguinal incision. General data of patients, intraoperative findings, operative time and postoperative complications were compared. RESULTS: Patient characteristics showed that the two groups were comparable.15 cases (31.9%) underwent intestinal resection, and 32 cases (68.1%) underwent first-stage tension-free repair in total. The rate of first-stage tension-free hernioplasty was significantly higher in the observation group (18/21, 85.7% vs 14/26 53.8%, P = 0.020). No additional incision was required in the observation group, while six cases of the control group (23.1%) had an additional incision for intestinal resection and anastomosis (P = 0.026). Mean operative time (53.6 ± 24.7 min vs 77.9 ± 36.5 min, P = 0.012) and the length of hospital stay (6.3 ± 4.2 days vs 10.3 ± 6.9 days, P = 0.020) were significantly shorter in the observation group. The time of return to normal physical activity resulted significantly reduced compared to the control group (9.2 ± 4.1 days vs 13.3 ± 6.6 days, P = 0.017). The total incidence of postoperative complication (including chronic pain, foreign body sensation, hernia recurrence, wound infection and seroma/hematomas) in the observation group was lower (14.3% vs 42.3% P = 0.037). There were two recurrences in the control group. No mesh-related infection and no mortalities in two groups. CONCLUSIONS: Midline preperitoneal approach for incarcerated and strangulated femoral hernia is a convenient and effective technique. It can improve the rate of first-stage tension-free repair of incarcerated femoral hernia and allow intestinal resection through the same incision, and with lower rate of postoperative complications.

Analysis of clinical effect on 19 cases of inguinal hernia treated by laparoscopic totally extraperitoneal repair / 国际外科学杂志

Objective To investigate the effect of laparoscopic total extraperitoneal tension-free hernia repair (TEP) in the treatment of inguinal hernia with absorbable biological mesh.Methods A retrospective analysis of the clinical data of 19 patients with inguinal hernia with biological mesh was performed from September 2015 to September 2016 in Shengjing Hospital of China Medical University.The average operative time,average incision pain time,average postoperative venting time,average hospital stay,average operative cost,and long-term chronic pain,postoperative complications,and recurrence rate were observed.Results All the 19 patients were successfully operated.The average operation time was (35.0 ± 4.0) min,the average incision pain time was (1.5 ± 0.6) d,and the average postoperative venting time was (1.5 ± 1.2) d.The average hospital stay was (4.5 ±0.9) d,the average surgery cost was (23 534.6 ± 1 259.9) yuan.Two patients developed swelling of the scrotum after surgery,and one patient developed postoperative fat liquefaction.All patients were followed up for 1 year by telephone,with no recurrence,no serious complications,and chronic pain discomfort.Conclusions The application of absorbable biopsy TEP is a good and reliable way to treat inguinal hernia.Postoperative patients have mild pain and low complication rate.There is no recurrence in recent follow-up,and the short-term effect is satisfactory.It is a reliable method for the treatment of inguinal hernia.The cost is high,and can be selected according to age and individual needs.

To explore the clinical effect of tension-free repair in the treatment of inguinal hernia in elderly patient / 中华老年医学杂志

Objective To explore the clinical effect of tension-free repair in the treatment of inguinal hernia in elderly patient.Methods A total of 124 elderly patients with inguinal hernia admitted in our hospital in 2016 were randomly divided into a study group(n=62)and a control group (n=62).The control group was treated with open tension-free inguinal hernia repair,whereas with laparoscopic tension-free inguinal hernia repair in the study group.The operation time,intraoperative blood loss,the postoperative pain relief-time,mean days of hospitalization,postoperative recurrence rate,and complications rates were compared between the two groups.Results The more significant improvements were found in study group versus control group in the intraoperative bleeding volume [(19.9±2.0)ml vs.(36.8±-2.5)ml,t=41.564,P=0.000],in the mean hours of postoperative pain [(22.1 ± 4.2) h vs.(35.3 ± 7.0) h,t =12.732,P =0.000],in mean days of hospitalization [(5.5 ± 1.0)d vs.(9.2±1.9)d,t=13.569,P=0.000],in incidence rate of postoperative recurrence(0.0％ vs.6.5％,x2 =4.133,P=0.042),and in postoperative complications rate(3.2％ vs.12.9％,x2 =3.916,P=0.048).Nevertheless,the operation time was longer in the study group than in the control group[(87.0±5.0)min vs.(55.5±4.2)min,t=-37.984,=0.000],Conclusions As compared with open tension-free repair,the clinical efficacy of laparoscopic tension-free hernia repair is exactly sure in the treatment of inguinal hernia,with shorter postoperative hospitalization time and lower incidence of complications.

[Evidence-based Lichtenstein technique]. / Die evidenzbasierte Lichtenstein-Technik.

Lichtenstein hernioplasty is the number one technique worldwide for open, mesh-based inguinal hernia repair. The principle of Lichtenstein hernioplasty is the tension-free reinforcement of the abdominal wall by covering the transversalis fascia and the oblique muscles with an artificial patch of mesh. The Lichtenstein technique has been modified since its inception. The technique has the benefits of low costs and a rapid learning curve and can be performed with the patient under local anesthesia. The recurrence rates after the Lichtenstein operation are significantly lower compared to open suture repair and equal to laparoendoscopic techniques. Compared to laparoendoscopic techniques the Lichtenstein operation is associated with less severe visceral lesions but more early postoperative and chronic pain; however, the chronic pain rates in long-term follow-up studies are comparable.

Present situation and prospect of the rapid development of hernia and abdominal wall surgery for 20 years in China / 中华消化外科杂志

Hernia is ancient and common.With the emerging of new concepts,techniques,materials and equipments,treatment methods of hernia have undergone ever-changing changes in the 21st century.Hernia and abdominal wall surgery in China has been developing fast in the past 20 years,and has achieved remarkable progress.However,some problems still exist,such as unbalanced regional development,concept misunderstanding,classification confusions,less standardized technology,poor follow-up method,lack of innovation,and so on.Therefore,it's crucial to recognize the shortcomings of the current stagey,discuss the existing problems,sum up experiences and lessons,and clarify the direction of improvement,in order to provide a solid foundation for the sustainable development of hernia and abdominal surgery for our country.

Application of fentanyl citrate combined with psychological intervention on the treatment of elderly patients with inguinal hernia tension-free repair / 中国生化药物杂志

Objective To investigate the effect of fentanyl citrate combined with psychological intervention on the treatment of elderly patients with inguinal hernia tension-free repair. Methods From May 2015 to May 2017, 110 elderly cases with inguinal hernia tension-free repair were divided into two groups, the control group and the observation group according to the different nursing intervention mode . The control group were received routine nursing intervention combined with midazolam. The observation group were given fentanyl citrate and routine nursing care combined with psychological intervention. The effect and safety in the two groups were recorded and compared. Results The curative effect in the observation group was remarkable, and the indexes during the operation were better than those in the control group. The incidence of adverse reactions was lower than that in the control group, and the nursing satisfaction was higher than that in the control group, the difference was statistically significant (P<0.05). Conclusion The effect is remarkable which Fentanyl citrate combined with routine nursing and psychological intervention were used on the treatment of elderly patients with inguinal hernia tension-free repair, the body indexes are stable, has less adverse reaction and high nursing satisfaction, is worthy of clinical application.

Clinical observation of preventive use of antibiotic inguinal hernial repair without tension and its significance / 吉林大学学报(医学版)

Objective:To explore the necessity of the preventive use of antibiotics and the effects of age and operation time on the efficacy of inguinal hernia repair without tension,and to elucidate the clinical significance of the preventive application of prophylactic antibiotics in inguinal hernia repair without tension.Methods:A total of 228 patients with inguinal hernia repair without tension were selected,amomg them 42 cases with high infection factors were treated with antibiotics (treated group),and 186 cases were not treated with antibiotics(untreated group) during the preoperative period.The prophylactic antibiotics were given 30 min before surgery,and the conventional dose was not used more than 48 h after surgery.All the cases were treated with artificial repair materials for the procedure of inguinal hernial repair without tension.The age,highest body temperature,white blood cell count,operation time,hospitalization time,and postoperative body temperature of all the 228 cases were recorded and analyzed statistically.Results:The preoperative and postoperative white blood cell counts had significant differences between the patients0.05).Compared with the patients with the operation time>90 min,the white blood cell count and hospitalization time of the patients with the operation time ≤90 min were increased (P90 min and the patients with the operation time≤90 min (P>0.05).The white blood cell count,operation time,hospitalization time and postoperative body temperature of the patients between treated group and untreated group had no significant differences (P>0.05).Conclusion:The use of antibiotics in the high-risk patients and non-use of antibiotics in the majority of elective inguinal hernia repair without tension can ensure the safe and performability of the patients.

Cost-conscious decisions in the timing of operation for minimally symptomatic inguinal hernias in male patients.

BACKGROUND: Expectant management (EM) and early open repair (OR) are safe and effective as initial management strategies for minimally symptomatic inguinal hernia in male patients. Extended follow-up of patients in EM protocols have shown that most patients will eventually require repair, but it is not clear which strategy is less costly over the long term. METHODS: We constructed a mathematical model to compare 3rd-party payer expenditures for EM vs OR or laparoscopic repair in a simulated cohort of patients with inguinal hernia. Cohort characteristics and expenditures were calibrated to recent randomized trials that reported initial follow-up and expenditures at 2 years and long-term crossover rates from EM to OR. RESULTS: Cost comparisons between OR and EM are sensitive to direct long-term costs of inpatient and outpatient care, the likelihood of crossover from EM to operation, cost differences between OR and laparoscopic repair, and the net present value of longer-term costs. CONCLUSIONS: Our findings suggest that short-term costs of EM are less than those of OR and Lap-R, but early OR provides the highest long-term savings.

Emergency surgery of groin incarcerated hernia and strangulated hernia in adults / 国际外科学杂志

Groin incarcerated hernia and groin strangulated hernia in adults are common acute abdominal disease,usually with aging,male-dominated inguinal direct and indirect hernia and female dominated femoral hernia,high mortality.Groin hernia medical history,hernia specialist checkup and imaging examination are quick and accurate diagnosis of adult groin incarcerated and strangulated hernia necessary prerequisites.Traditional hernia surgery,tension-free repair,laparoscopy tension-free repair are commonly used in emergency surgery of groin incarcerated hernia and strangulated hernia in adults.The aim of this article is to summarize the timing of surgery and surgical methods of groin incarcerated and strangulated hernia in adults.

Giant inguinoscrotal hernia repaired by lichtensteins technique without loss of domain -a case report.

Giant inguinal hernia is a formidable surgical problem. It is defined as inguinal hernia extending up to mid thigh or below in standing position. Giant inguinal hernia is usually associated with compromised quality of life due to sexual discomfort and constant weight bearing. It is a challenge for the operating surgeon since it is rare. It may require multistage repair with recurrence being common. A 45-year-old male patient presented with Giant inguinal hernia and compromised quality of life due to pain and sexual discomfort. Lichtenstein's polypropylene mesh repair was done after reducing the sac contents (omentum and transverse colon) with partial omentectomy. There was no loss of intra-abdominal domain. Postoperative period was uneventful. In literature many techniques are available to increase the intra-abdominal cavity (a) Creating progressive preoperative pneumoperitoneum (b) Creation of ventral wall defect (c) surgical debulking of hernia contents. Recurrence is prevented by reconstruction of the abdominal wall using Marlex mesh and a Tensor fasciae lata flap. Laparoscopic repair is associated with more recurrence. Lichtenstein's technique is one of the preferred treatments.

Kugel hernioplasty via anterior approach for inguinal hernia repair / 中国医师进修杂志

ObjectiveTo evaluate the clinical application of Kugel hernioplasty via anterior approach for inguinal hernia repair.MethodsA retrospective study was made to analyze the clinical data of 851 cases(956 hernias) treated with Kugel hernioplasty via anterior approach for inguinal hernias from November 2005 to May 2011.ResultsOperative duration was(42 ± 11) minutes.The postoperative complications were detected on 21 hernias of seroma,8 hernias of hematoma,12 hernias of sub dermal ecchymosis,26 hernias of foreign body sensation and 5 hernias of recurrence.No incision infection occurred.Conclusions Kugel hernioplasty via anterior approach can repair and strengthen the whole anatomy area of myopectineal orifice.It is available for various kinds of inguinal hernias.

A comparison between opening total extraperitoneal herniorrhaphy and traditional anterior approach on tension-free repair of inguinal hernia / 国际外科学杂志

Objective To evaluate the effects of the two different operations, such as open total extraperitoneal herniorrhaphy or traditional anterior approachs on tension-free repair of inguinal hernia. Methods In a prospective randomized controlled study, 165 cases with inguinal hernia were allocated randomly to either the anterior approach group (82 cases)or open total extraperitoneal herniorrhaphy group( 83 cases ).The index including the operation time, hospital stay, mean expense, time for returning to normal activity,and the recent or long-term operative complications and recurrence rate, were observed to evaluate the curative effect of open total extraperitoneal herniorrhaphy approach. Results The follow-up rate were 98.79% ,after (20.52 ± 1.54) months in average follow-up in the anterior approach group and (21.63 ± 1.76) months in the TEP group, and no significant differences were recorded between the two groups in the operation time, hospital stay, time for returning to normal activity, recurrence rate(3.66% vs 1.22% ) and urinary retention ( P > 0. 05 ), but operative complications in TEP group were significantly less than that in anterior approach group (P< 0.05). Conclusions The operative complications or postoperative unwell decrease significantly through the open total extraperitoneal herniorrhaphy approach in repairing inguinal hernias. Its curative effect was confirmed and deserves to be clinically popularized.

Prolene hernia system in the tension-free repair operation of inguinal saddle hernia / 国际外科学杂志

Objective To explore the therapeutic efficacy and operation experience of Prolene Hernia System (PHS) in the tension-free repair operation of inguinal saddle hernia. Methods All 41 cases using PHS were selected as the subjects of this study and the results were analyzed. Results All patients were performed operation under the local anesthesia, and lasted from 25 min to 60 min. They had been keeping in ward for observation from 24 h to 72 h. No serotal swelling, hematoma, and incisional wound infection hap-pened after the operation. The follow-up time had been lasting from 6 months to 42 months, and none of pa-tients catehed a relapse or had the sensation of the foreign bodies. Conclusions Using PHS is safe and ef-fective in the tension-free repair operation, and it is more suited to inguinal saddle hernia. The key of opera-tion success is attaching importance to operation skills.