Panel No. 5

There are rare cases where surgical findings demonstrate insufficient or very weak tissue to perform a Shouldice repair. These can be due to multiple prior failed hernia repairs, the prior use of mesh and a history of a deep wound infections following hernia repair. In these instances, the tissue needed to perform a Shouldice repair are deficient and risk a high rate of failure.

The Modified Shouldice Repair allows the surgeon to proceed with a standard Shouldice repair but reinforces the repair with a small latest generation mesh. This strengthens the weakened tissue used for the repair thereby markedly reducing the risk of a recurrence. The size of mesh used at the Hernia Center of Ohio is approximately 2 inches by 2 ½ inches or a total of about 5 square inches. In comparison, the laparoscopic and robotic hernia repairs require sizes in the range of 50 square inches or larger. Clearly the potential for mesh complications is greatly reduced with the comparatively tiny size of mesh used in the Modified Shouldice Repair.

This panel demonstrates the mesh being placed over the completed Shouldice tissue repair to reinforce the repair. Note the slit in the mesh is sutured together behind the internal ring to snug the spermatic cord and prevent any hernia from developing at the internal ring.