Inguinal hernia repair in German military hospitals.

The inguinal hernia repair continues to be the most common operation in general surgery. Discussing the latest scientific findings, we have prepared this article to present a state-of-the-art approach to the inguinal hernia repair. This approach is used for discussing the general principles of hernia repair in German military hospitals. Quality assurance requires that all hernias be classified during surgery on the basis of a standardized approach for an objective comparison of treatment and outcomes. Our approach to hernia repair considers the age of the patient, the diameter and location of the hernia and whether or not the herniation is recurrent. The Shouldice technique performed under local anesthesia is defined as the standard approach in young patients. The use of prosthetic meshes continues to be the ideal method for repairing large medial fascial defects and recurrent hernias. Endoscopic procedures are particularly suitable for the bilateral repair and recurrent hernias.