An anterior transversalis fascia repair for adult inguinal hernias.

During the eight year period from 1967 to 1975, 1,020 patients more than eighteen years old underwent 1,311 inguinal herniorrhaphies. Group I consisted of 723 inguinal herniorrhaphies in which either a Bassini or a Cooper's ligament repair was used. During a four to nine year follow-up period, the total recurrence rate was 11.5 per cent; the recurrence rate for the primary repair group was 7 per cent and for the recurrent group 32 per cent. The follow-up rate was 93.7 per cent. Group II consisted of 591 herniorrhaphies in which the repair was performed by an anterior transversalis fascia technic. During a two to five year follow-up period, the total recurrence rate was 2.7 per cent; 1.8 per cent for primary repairs and 8.0 per cent for recurrent hernias. The follow-up rate was 98 per cent (95 per cent by personal examination). Assuming that the recurrences in group II will occur with the same frequency as in group I, our projected four to nine year recurrence rate is 3.4 per cent. This suggests that the anterior transversalis fascia repair results in a lower recurrence rate than either the Bassini or Cooper's ligament repairs.