Skip to main content

Advertisement

SpringerLink
Log in

Lichtenstein tension-free hernioplasty: Its inception, evolution, and principles

  • Pioneers in Hernia Surgery
  • Published:
Hernia Aims and scope Submit manuscript

Abstract

To circumvent the degenerative nature of inguinal hernias and adverse effect of suture line tension, the Lichtenstein tension-free hernioplasty began in 1984 and evolved (between 1984 and 1988) to a procedure that is now considered the gold standard of hernia repair by the American College of Surgeons. The objective of this paper is to outline the reasons behind the minor changes made during the short, 4-year evolution of the technique, describe the key principles of the operation, and introduce a new mesh that, if elected to be used, automatically satisfies all the key principles of the procedure and guides the surgeon to perform the operation correctly. The worldwide reported result of the operation by experts and nonexperts alike is a recurrence and complication rate of less than 1%. When the key principles of the procedure, which, as reported by many authors, are easy to learn, perform, and teach, are respected, the operation results in an effectiveness (external validation) that is virtually the same as its efficacy (results of the experts), attesting to the simplicity of the procedure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1.
Fig. 2.
Fig. 3.
Fig. 4.
Fig. 5.
Fig. 6.

Similar content being viewed by others

References

  1. Read RC (1992) A review: the role of protease-antiprotease imbalance in the pathogenesis of herniation and abdominal aortic aneurism in certain smokers. Postgrad Gen Surg 4:161-5

    Google Scholar 

  2. Rosch R, Klinge U, Si Z, Junge K, Klosterhalfen B, Schumpelick V (2002) A role for the collagen I/III and MMP-1/-13 genes in primary inguinal hernia? BMC Med Genet 3:2

    Article  PubMed  Google Scholar 

  3. Wantz, GE (1996) Experience with tension-free hernioplasty for primary inguinal hernias in men. J Am Coll Surg 193:351–360

    Google Scholar 

  4. Nyhus LM (1989) The preperitoneal approach and iliopubic tract repair of inguinal hernia. In: Nyhus LM, Condon RE (eds), Hernia, Third Edition, J.B. Lippincott Company, Philadelphia, Pennsylvania, pp154–177

  5. Lichtenstein IL (1987) Herniorrhaphy. A personal experience with 6,321 cases. Am J Surg 153:553–559

    CAS  PubMed  Google Scholar 

  6. Amid PK, Shulman AG, Lichtenstein IL (1993) Critical scrutiny of the open tension-free hernioplasty. Am J Surg 165:369–71

    CAS  PubMed  Google Scholar 

  7. Amid PK, Shulman AG (1993) Tension-free repair of inguinal and aponeurotic hernias. G Chir 14:145–154

    CAS  PubMed  Google Scholar 

  8. Drye JC (1948) Intraperitoneal pressure in the human. Surg Gynecol Obstet 87:472–475

    Google Scholar 

  9. Amid PK (1997) Classification of biomaterials and their related complications in abdominal wall hernia surgery. Hernia 1:12–19

    Google Scholar 

  10. Klinge U, Klosterehalfen B, Muller M, et al. (1998) Shrinking of polypropylene mesh in vivo: An experimental study in dogs. Eur J Surg 164:965

    PubMed  Google Scholar 

  11. Amid PK, Shulman AG, Lichtenstein IL, Sostrin S, Young J, Hakakha M (1994) Experimental evaluation of a new composite mesh with the selective property of incorporation to the abdominal wall without adhering to the intestines. J Biomed Mater Res 28:373–75

    Google Scholar 

  12. Amid PK, Shulman AG, Lichtenstein IL (1994) Local anesthesia for inguinal hernia repair step-by-step procedure. Ann Surg 220:735–737

    CAS  PubMed  Google Scholar 

  13. Amid PK (2000) Driving after repair of groin hernia. BMJ 321:1033-1034

    Article  CAS  PubMed  Google Scholar 

  14. Katz EE, Patel RV, Sokoloff MH, Vargish T, Brendler CB (2002) Bilateral laparoscopic inguinal hernia repair can complicate subsequent radical retropubic prostatectomy. J Urol 167:637–638

    PubMed  Google Scholar 

  15. Stoppa R, Diarra B, Verhaeghe P, Henry X (1998) Some problems encountered at re-operation following repair of groin hernias with pre-peritoneal prostheses. Hernia 2:35–38

    Google Scholar 

  16. Borchers H, Brehmer B, van Poppel H, Jakse G (2001) Radical prostatectomy in patients with previous groin hernia repair using synthetic nonabsorbable mesh. Urol Int 67:213–5

    Article  CAS  PubMed  Google Scholar 

  17. Liberman MA, Rosenthal RJ, Phillips EH (2002) Laparoscopic ventral and incisional hernia repair: A simplified method of mesh placement. J Am Coll Surg 194:93–95

    Google Scholar 

  18. Losanof JE, Richman BW, Jones JW (2002) Laparoscopic repair of incisional hernia. Which prosthesis to choose? Surg Endosc 16:1500–1501

    Article  PubMed  Google Scholar 

  19. Ferrando JM, Vidal J, Armengol M, Gil J, Manero JM et al. (2002) Experimental evaluation of a new layered prosthesis exhibiting a low tensile modulus of elasticity: Long-term integration response within the rat abdominal wall. World J Surg 26:409–415

    Article  PubMed  Google Scholar 

  20. Gillian GK, Geis WP, Grover G (2002) Laparoscopic incisional and ventral hernia repair (LIVH): an evolving outpatient technique. JSLS 6:315–22

    PubMed  Google Scholar 

  21. Amid PK (2002) A 1-stage surgical treatment for postherniorrhaphy neuropathic pain. Triple neurectomy and proximal end implantation without mobilization of the cord. Arch Surg 137:100–104

    Article  PubMed  Google Scholar 

  22. Fitzgibbons R (2000) Management of an inguinal hernia: Conventional? Tension-free? Laparoscopic? or maybe no treatment at all. General Sessions of the American College of Surgeons. 86th Annual Clinical Congress

    Google Scholar 

  23. Shulman AG, Amid PK, Lichtenstein IL (1995) A survey of non-expert surgeons using the open tension-free mesh repair for primary inguinal hernias. Int Surg 80:35–36

    CAS  PubMed  Google Scholar 

  24. Kingsnorth AN, Bowley DMG, Porter C (2003) A prospective study of 1000 hernias: results of the Plymouth Hernia Service. Ann R Coll Surg Engl 85:18–22

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Lichtenstein Hernia Institute, 5901 W. Olympic Boulevard Suite 207, Los Angeles, CA 90036, USA

    Parviz K. Amid

  2. Department of Surgery, Harbor-UCLA, Los Angeles, Calif., USA

    Parviz K. Amid

  3. Department of Surgery, Cedars-Sinai Medical Centers, Los Angeles, Calif., USA

    Parviz K. Amid

Authors
  1. Parviz K. Amid
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Parviz K. Amid.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Amid, P.K. Lichtenstein tension-free hernioplasty: Its inception, evolution, and principles. Hernia 8, 1–7 (2004). https://doi.org/10.1007/s10029-003-0160-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10029-003-0160-y

Keywords

Search

Navigation