The ONSTEP inguinal hernia repair technique: initial clinical experience of 693 patients, in two institutions

Hernia, 03/01/2013

Lourenco A et al. – Experience with a novel hernioplasty procedure—the ONSTEP approach—for inguinal hernia repair in a large series of patients performed by two surgeons at two institutions is described, focusing in particular on the duration of surgery, the time taken to return to normal activities, chronic pain, complication and recurrence rates. The ONSTEP inguinal hernia repair technique described is simple, quick to perform, produces consistent results and is associated with very low overall complication, chronic pain and recurrence rates. It may offer an alternative to both Lichtenstein and laparoscopic inguinal hernia repair.


  • Adult patients underwent inguinal hernia repair using the ONSTEP approach.
  • The hernia defect was repaired using a PolySoft™ hernia patch.
  • Patients were followed up for 1 year for pain, complications and recurrences.


  • A total of 693 patients underwent ONSTEP inguinal hernia repair.
  • The mean duration of surgery (±SD) was 17 ± 6 min; the time to discharge from hospital was less than 24 h in all patients; and the mean time to return to normal daily activities was 6.1 ± 3.0 days.
  • The overall complication rate was 1.0 % and the overall recurrence rate was 0.6 %.
  • Residual pain was present in 4 patients at 6 months and was cured by removal of the memory ring in 3 patients and disappeared spontaneously in one case, so that there was no case of chronic pain at 1 year.

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