The Preperitoneal Prosthetic Approach for the Repair of Recurrent Inguinal Hernia: Is There Still a Place for the Wantz Technique?

Recurrent inguinal hernia remains a significant clinical problem despite advances in surgical techniques. Comprehensive audit from national hernia registers in Sweden [1] and Denmark [2] has shown an incidence of recurrence of 16-18% following primary repair. Recurrence rate of over 30% has been reported [3]. Increasing use of prosthetic mesh has improved the recurrence rate because old non-prosthetic techniques have two common defects: the first one is represented by tension on the suture line. In fact the major part of the recurrences are positioned near the end of the suture (47% near the pubic tubercule and 40% near the internal inguinal ring) where the tension is higher. The second is due to the consideration that the same metabolical problems that have caused the first hernia appearance, had same involved in the recurrences if no used prosthetic repair [4].