Shouldice Hernia repair

Shouldice No-Mesh Hernia Surgery Procedure

Canadian surgeon Dr. Edward Earle Shouldice developed a unique way to repair hernia without using artificial mesh or any other prosthesis to allow the patients to be eligible for World War II military service.

Shouldice hernia repair is one of the most advanced surgery methods to treat hernia without using an artificial mesh. This method is welcomed and preferred by many patients because the recurrence rate is less than 0.5% based on decades of clinical data, and of most importance doesn't include the use of plastic mesh but relies on the surgeon’s skills to fix the hernia with the patient’s own nearby natural tissue.

The Shouldice hernia repair surgery differs from other mainstream methods because it is a slower, more detailed process and relies much less on better pieces of plastic or robotic surgery and more on the skill of the surgeon. In the hands of our experienced surgeons, this delicate hernia surgery is one of the safest and most effective methods for repairing the minor defect that is caused by a hernia.  We don’t need an expensive piece of plastic to fix the minor defect that is usually the problem.

Mesh-based repair introduces an artificial implant that makes it more likely for the wound to become infected and the repair to fail.  The artificial mesh then must be surgically removed completely in the event of such infection. It can therefore seriously complicate any hernia repair.\


Shouldice Surgery Procedure

Shouldice hernia repair procedure is used to treat inguinal hernia and femoral hernia, the former being more common.

Preoperative Care

  • Physical examination and diagnostic methods will document the patient's hernia, noting the size and location. We attempt to differentiate between an inguinal and femoral hernia, based on the position relative to the inguinal ligament.
  • Weight reduction and exercise are advised, but they are skipped if the pain is intense enough to prevent everyday activities.

Operating Procedure

Ansa Health Care adheres to the Shouldice technique of repair in large part, however, we no longer use stainless steel suture as Dr. Shouldice first did, we use modern suture material. We also allow patients to go home the day of surgery, with no requirement for overnight stay.  We don’t require steel clip removal in the days after surgery.

The surgical procedure is usually performed under local anaesthetic, with some pain pills and sedative before surgery. There is no requirement for general anaesthesia and robots to help with surgery.

During the operation, the incision itself depends on your size, but is generally only 3-4 inches in length. We prefer this 'open' technique of surgery as it allows your surgeon the best view of all your tissues at the surgery site. Surgeons can see nerves and vessels up close to manage them properly, not at a distance with laparoscopic surgery.


In the repair of groin hernias, we design a tailored (to you), hand sewn, continuous, meshwork of flexible, permanent, modern suture material.   It is placed, in layers, into the floor of the inguinal canal. The muscles are gently placed without undue tension (pulling) into a flexible, vital, alive and reinforced framework next to each other using the inguinal ligament at its base. We are also able to replace and repair individual vessels and ligaments, essentially putting everything back where it belongs in one procedure.

The skin is closed with rapid-dissolving sutures, rather than staples or clips, and the site is dressed before the patient is released. We strive for minimal tension or pulling during this procedure, allowing patients to remain comfortable throughout the procedure.

Benefits of Surgery

Because the incision for the Shouldice repair method is slightly longer than other hernia repair methods, surgeons have a better view of the procedure. This allows them to investigate the nearby areas and prevent any future nearby hernias, which is not rare.

The artificial mesh used in many hernia surgeries tends to shrink over time and, because of its placement, is subject to a lot of pulling and stretching. Rather than relying on artificial mesh, we allow the body to heal itself by overlapping your own muscle and tissue, which reduces pulling from tension during the repair.


Surgery Cost

The Shouldice hernia surgery costs between USD$3,000 to $8,000 depending on the type of surgery.


Contact ANSA Health Care

Reach out to ANSA to assure yourself of competent diagnosis, natural hernia repair with very low incidence of complications.

ANSA Contact Information:

Natural Tissue Hernia Repair Associates

33 Beverly Hills Dr.

Toronto ON M3L 1A2


Toll-Free Phone: 1 (877) 681-6002




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