Shouldice is a 4-layer repair. There are surgeons who do 2 of these with permanent sutures, and 2 with absorbable. Dr. Wiese, for example. I think Dr. Koch does it that way too. They claim good results.
I don’t know about “2-layer Shouldice”.
Not sure this is something that’s worth obsessing about too much. My understanding is that a clinically significant reaction to the sutures is extremely rare.
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