Thomas H . Quinn , Ph . D . 2 7 OPEN HERNIA REPAIR

Herniorrhaphy is one of the most commonly performed operations in all of surgery. Worldwide, some 20 million groin hernia repairs are accomplished each year.1 In the United States, over 1,000,000 herniorrhaphies are performed each year, of which 750,000 are for inguinal hernias, 166,000 for umbilical hernias, 97,000 for incisional hernias, 25,000 for femoral hernias, and 76,000 for miscellaneous hernias.2 The significance of these large numbers is that small variations in practice patterns can have huge socioeconomic implications. Operations that might seem unimportant because they account for only a small percentage of herniorrhaphies actually are important in that they account for a large absolute number of procedures. Accordingly, though this chapter is necessarily selective, focusing on the most pertinent of the abdominal wall and groin herniorrhaphies being performed today, it addresses a wide variety of operative approaches to hernia repair.