Hernia Treatment

In the Munich Hernia Center we have used the Shouldice technique consistently for over 12 years now. A few years ago we introduced a variety of well established and new surgical techniques. This was the prerequisite to treat each patient individually leading to the new concept of “tailored surgery”: Every patient gets his own individual surgical hernia repair tailored to his needs.

Depending on the needs of the patients that is age, occupation, general health, physical activities and the size and degree of the hernia, the surgical technique is chosen carefully between following methods.

This is a technique we use in over 70% of our patients. It was developed by us with the experience of having operated on over 12,000 hernias successfully.
The technique is completely mesh free and is mainly designed for professional athletes with a sportsman’s hernia (pubalgia) or other patients with a small defect and hernia. Since the surrounding tissues are undamaged we only open up the area of the defect without injuring intact areas. Due to this extremely sparing surgical technique the patient has less pain and can start strenuous physical exercise after 2 days already.

The main feature of this gold-standard technique is an elastic doubling of each abdominal layer. The smoothness of all the layers thus is completely retained. Physical immobility is therefore not necessary and the patient can start to work a few days after surgery.
Another advantage of this method is the very small likelihood of a recurrent hernia. The Shouldice Technique is mesh free and is used for patients who have big defect in the transverse fascia of the inguinal canal but stable layers and muscles.

With the Lichtenstein technique, the defect is repaired with a normal suture and a square mesh is laid and sutured on top of the most anterior muscle layers. The Lichtenstein technique is mostly used for the elderly patient, however only when the abdominal wall is not sufficiently stable to allow a primary suture.

Since 1995 we have been using the mesh-plug technique in our hernia center. A preformed mesh (umbrella shaped) is sutured into the defect to achieve a complete tension-free closing of the defect.
This technique gets mostly used in patients whose stability of the abdominal wall is insufficient due to age, excess fatty tissues or multiple surgical repairs in the abdominal area.
Like with the Shouldice technique, physical rest is not necessary.

This technique is based on the surgical technique of Dr. Rives. A wide mesh is placed underneath the abdominal facial between abdominal wall and peritoneum. This technique is necessary for patients who show an insufficiency of the posterior wall only, but have taut and stable tissues otherwise.


We refrain from using Laparoscopic- / Endoscopic techniques due the specific disadvantages like general anesthesia, compulsory implantation of large meshes and a high frequency of severe intra- and post-operative complications.