Bassini inguinal hernia repair: Obsolete or still a viable surgical option? A single center cohort study

Abstract

ABSTRACT Background: Most inguinal hernias are presently repaired using some type of mesh technique. This mesh can be placed through an inguinal incision or positioned through a laparoscopic approach. Either way, results have been impressive including a low recurrence rate, minimal pain and a rapid return to work and normal activity compared to tissue based approaches. Notwithstanding these results, there is still a subset of patients who, for various reasons, are strongly opposed to having a mesh repair. This study summarizes our 13 year experience with such patients and why the Bassini hernia repair is a viable surgical option in these individuals. Methods: Patients undergoing a Bassini repair at our institution from 2006 to 2014 were analyzed for long-term durability of the repair, complications and recurrence rate. Results: Of 203 patients studied (average age 65; 99% male), 205 repairs (two patients had bilateral repairs) were evaluated. Seven documented recurrences (3.7%) were identified. Post-operative complications were relatively minor and easily managed. They included 22 patients (10.8%) with a wound hematoma/seroma, 17 (8.4%) with urinary retention, and four (2%) with testicular ischemia not requiring orchiectomy. Pain problems (10.3%) were generally transient and resolved in a period of weeks. In those patients who did not die from co-morbid disease, long term durability of repair (≥5 years) was quite common. Conclusion: Low recurrence rate, long term durability and relatively minor complications indicate that the Bassini repair is still a good surgical option in patients opposed to a mesh repair. As such, we argue that it is not obsolete but still remains a viable surgical option in selected patients. Highlights