Does chosen approach to the inguinal canal affect the outcome of hernial repair?

Access to the posterior inguinal wall is a fundamental part of inguinal hernia repair. The approach to the inguinal canal may affect the course and outcome of the operation. The aim of this study is to compare posterior approach (PA) repair with the standard anterior approach (AA). The study included 91 low-risk unilateral primary inguinal hernia patients who randomly received AA repair or PA repair. Various outcome measures in both groups were compared, and the mean operating time was longer for the AA repair group. Intra-operative complications were the same in both groups. Postoperative complications were more frequent in the AA repair group. The at-rest mean visual analog score (VAS), 24 hours postoperatively, seemed to be higher in the AA repair group. AA patients were able to postoperatively walk sooner than PA patients. Inguinal hernia repair through a PA seems to be less painful, less debilitating, and more easily applicable than the AA. Such advantages may be the reasons to select it as a standard procedure of choice.