Inguinal hernia repair: The total picture

Bassini in 1988 posted a milestone in the history of not only hernia surgery but of all surgery when he reported a reduction in the recurrence rate from 100 to 10% with his operation which was a unique combination of understanding of anatomy and application of surgical thinking and technique. This 10% recurrence rate was achieved at a period without antibiotics, primitive anaesthesia and when patients suffered their hernia to giant size before submitting to surgery. Over nine decades Bassini’s tissue repair procedures – with several modifications (Halsted, McVay, Tanner, Shouldice....) has helped preserve useful life in hundreds of thousands cases. While most “herniologists” view tissue repair as a method in disrepute to be discarded, its very economical cost structure makes it even today the commonest form of hernia repair in most part of the developing world and even in Canada tissue repair (Shouldice) accounts for 25% of all inguinal hernia repair.