A FUNDAMENTAL FACTOR IN THE RECURRENCE OF INGUINAL HERNIA

Abstract

The modern operation for the repair of inguinal hernia may be said to date from 1889 and 1890, when Halsted and Bassini published their studies. It may also be said with assurance that the thirty odd years' experience gained from the performance and study of this operation has taught surgeons that the fundamental principles underlying the permanent operative cure of hernia are: (1) high ligation of the sac; (2) adequate reinforcement of the defective abdominal wall, and (3) primary wound healing. No one of these three requirements is particularly elusive, nor does any one of them seem difficult of accomplishment. Yet the percentage of postoperative recurrences is far from encouraging. Unfortunately, there exists a disconcerting divergence of opinion regarding the frequency of recurrence, a divergence which ranges all the way from 0.8 to 12 per cent., both groups of figures coming from surgeons of enviable reputation. One cannot help feeling