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Primary tissue repair for inguinal hernia involves repairing the hernia using the patient's own tissues, without the use of synthetic mesh. This approach is also known as "anatomical repair" or "tissue-to-tissue repair". Techniques: 1. Bassini repair: A classic technique that involves suturing the conjoint tendon to the inguinal ligament. 2. Shouldice repair: A modification of the Bassini technique that involves imbricating (folding) the hernia sac and reinforcing the repair with additional sutures. 3. McVay repair: A technique that involves suturing the hernia sac to the Cooper's ligament. Advantages: 1. No foreign body reaction or mesh-related complications 2. Lower risk of chronic pain and discomfort 3. Potential for quicker recovery Disadvantages: 1. Higher recurrence rate compared to mesh-based repairs 2. Requires expertise and experience 3. May not be suitable for large or complex hernias Indications: 1. Small to moderate-sized hernias 2. Patients with a high risk of mesh-related complications 3. Patients who prefer a non-mesh repair Contraindications: 1. Large or complex hernias 2. Patients with significant tissue weakness or defects 3. Recurrent hernias that have previously been repaired with primary tissue repair. #inguinalhernia