Shifting the Paradigm. Rutkow-Robbins Modified by Maldonado: Our Technique for Open Inguinal Hernia Repair, Outcomes and Review of the Literature

Approximately 20 million hernia surgeries are performed worldwide each year. The majority of groin hernia repairs are conducted electively and are regarded as low-risk procedures [1, 2]. In our Center, a developing country with government hospitals, laparoscopic available resources are sometimes insufficient to meet the demand for patients with inguinal hernias. As a result, open repair remains widely performed procedure. Based on this, we made a modification to the Rutkow-Robbins technique by applying its two fundamental physical principles—a plug and a mesh patch— reducing the prosthetic mesh used, and for the first time, shifting the paradigm regarding the effect of polypropylene mesh when in contact with the spermatic cord. This modification has shown favourable outcomes in a two-year follow-up. The aim of this paper is to describe our technique and present the outcomes achieved.