A very powerful principle of healing a disruptive injury anywhere in the body is to close and stabilize the injury in some way and then allow it to heal. Broken bones are aligned and held in place by a cast or plates and screws. The bones then heal back to normal. A severed nerve is healed by suturing the cut ends together and then allowing it to heal. Intestine that is cut in surgery to remove a cancer is sutured back together and then allowed to heal. A skin laceration is repaired with sutures and then is allowed to heal.
A hernia is a disruptive injury to abdominal fascia. Intestines and abdominal organs protrude through the disruption forming what we call a hernia. You can plug the disruption or you can patch it but the most natural way to heal it is to close the disruption with sutures and then allow it to heal. A hernia that is treated in this way results in restoration of normal anatomy. We haven't put a plug in you. We haven't patched you. We haven't rearranged your normal anatomy. Its all back to normal and there is nothing in you for your body to reject or to poke you from inside. Movement is natural and painless.
Non-mesh hernia repairs all adhere to two principles. The McVay, the Bassinni, the Shouldice and a dozen other named repairs all adhere to these two principles: 1) identify, remove and ligate the indirect sack. 2) Suture close the disrupted area of the transversalis fascial floor of the inguinal canal which is the site of direct hernias.
This is how I repair inguinal hernias. The procedure that I use does not have a name because it is similar to all named non-mesh hernia repairs through the two principles listed above. There are fine points to my technique which I have adopted from all of the hernia repairs that I was taught to perform and a few refinements I invented by myself. The results are that I successfully repair hernias without mesh more than 97% of the time. Also none of my patients develop severe chronic pain after their non-mesh hernia repair. My career experience is over 5,000 hernia repairs.
"Milan—Chronic groin pain after hernia surgery is now considered the most important issue facing inguinal hernia surgeons and their patients. Yet, there is still much uncertainty surrounding what causes the pain and how to prevent it." - Victoria Stern, General Surgery News
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