ZenToks Publication

Chapter 22

The Mesh Plug Repair for Inguinal Hernia in Adults: A Review

Abstract/Preface

Inguinal hernia repair ranks among the most frequently performed surgical procedures globally. The advent of prosthetic mesh has markedly decreased recurrence rates and revolutionized the management of groin hernias. Among the tension-free techniques developed, the mesh plug repair, introduced by Rutkow and Robbins in the 1990s, has emerged as a straightforward and effective method. This technique involves the insertion of a conical polypropylene mesh plug into the hernia defect, supplemented by additional mesh reinforcement when necessary. Its widespread acceptance is attributed to its technical simplicity, brief operative duration, low recurrence rates, and suitability for outpatient surgery. Nonetheless, concerns regarding mesh-related complications, such as migration, chronic pain, erosion into adjacent organs, and foreign body sensation, have prompted increased scrutiny of this technique. Recent international hernia guidelines have increasingly endorsed flat mesh repairs and laparo-endoscopic approaches over mesh plugs. This chapter examines the mesh plug repair, its clinical outcomes, advantages, limitations, complications, and its contemporary role in inguinal hernia surgery. Additionally, we compare the mesh plug repair with other open mesh inguinal hernia repairs and laparoscopic inguinal hernia repairs.