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<p>The Shouldice technique is a standardized, open, mesh-free procedure for inguinal hernia repair developed by E.E. Shouldice and refined at the Shouldice Hospital in Canada. In the absence of a universal gold standard for groin hernia surgery, it remains an important option, particularly for patients who prefer a non-mesh repair. The operation can usually be performed under local anesthesia and requires meticulous anatomical dissection.The central element of the procedure is a four-layer reconstruction of the posterior inguinal wall using a continuous suture technique. This multilayer repair provides strong&#xa0; reinforcement and controlled reconstruction of the internal inguinal ring. Recent high-volume studies report recurrence rates of approximately 1.6%, comparable to established mesh-based techniques. Updated HerniaSurge guidelines confirm similar short-term outcomes to Lichtenstein and&#xa0; laparo-endoscopic repairs in carefully selected patients when expertise is available.</p>

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The standardized Shouldice procedure

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月30日

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  • Christoph Paasch,
  • Ralph Lorenz,
  • René H. Fortelny

摘要

The Shouldice technique is a standardized, open, mesh-free procedure for inguinal hernia repair developed by E.E. Shouldice and refined at the Shouldice Hospital in Canada. In the absence of a universal gold standard for groin hernia surgery, it remains an important option, particularly for patients who prefer a non-mesh repair. The operation can usually be performed under local anesthesia and requires meticulous anatomical dissection.The central element of the procedure is a four-layer reconstruction of the posterior inguinal wall using a continuous suture technique. This multilayer repair provides strong  reinforcement and controlled reconstruction of the internal inguinal ring. Recent high-volume studies report recurrence rates of approximately 1.6%, comparable to established mesh-based techniques. Updated HerniaSurge guidelines confirm similar short-term outcomes to Lichtenstein and  laparo-endoscopic repairs in carefully selected patients when expertise is available.