Year: 2026
Type: article
Abstract: Summary The Shouldice technique is a standardized, open, mesh-free procedure for inguinal hernia repair developed by E.E. Shouldice and refined at the Shouldice Hospital in Canada. In the absence of a universal gold standard for groin hernia surgery, it remains an important option, particularly for patients who prefer a non-mesh repair. The operation can usually be performed under local anesthesia and requires meticulous anatomical dissection.The central element of the procedure is a four-layer reconstruction of the posterior inguinal wall using a continuous suture technique. This multilayer repair provides strong reinforcement and controlled reconstruction of the internal inguinal ring. Recent high-volume studies report recurrence rates of approximately 1.6%, comparable to established mesh-based techniques. Updated HerniaSurge guidelines confirm similar short-term outcomes to Lichtenstein and laparo-endoscopic repairs in carefully selected patients when expertise is available.
Authors: Christoph Paasch, Ralph Lorenz, René H. Fortelny
Language: English
Topic: Hernia repair and management
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $2,890
OpenAlex ID: W7126194684