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After the introduction of Bassini's procedure in the late 19th century, methods of repairing hernias changed little until the 1990s, when synthetic mesh and laparoscopic methods arrived. (1) In contrast to the open mesh technique, laparoscopic surgery remains uncommon. In January 2001, the National Institute for Clinical Excellence (NICE) issued guidance that stated, "For repair of primary inguinal hernia, open [mesh] should be the preferred surgical procedure." (2) We describe patterns of surgical repair of inguinal hernias and assess the impact of NICE's guidance.
Methods and results
We found 217 000 cases with a primary procedure code for primary surgery for an inguinal hernia from the hospital episode statistics database for England …