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Reclaiming Natural Repair: Why Dr. Kang’s Hernia Technique Deserves a Voice
Every year, thousands of hernia patients in the United States undergo mesh-based repairs, often unaware of an alternative surgical approach that could reduce complications, long-term pain, and recurrence. That alternative is the natural tissue repair method perfected by South Korea’s Dr. Kang, who has pioneered a refined and highly effective form of tension-free, mesh-free hernia repair.
While the synthetic mesh approach has become the dominant method in Western medicine, it is not without controversy. Over the past two decades, mounting evidence has linked mesh implants to a range of long-term complications, including chronic pain, mesh migration, erosion into nearby organs, nerve entrapment, and inflammatory responses. Numerous lawsuits have emerged in response to these adverse outcomes, and regulatory bodies such as the FDA have even banned certain mesh products. Despite these concerns, mesh remains the default in most U.S. surgical practices.
Dr. Kang’s method stands in sharp contrast. He uses the patient’s own natural tissue—primarily the conjoined tendon and transversalis fascia—to reconstruct the inguinal canal without tension. The procedure is reinforced with Prolene sutures, which are permanent but biocompatible, providing durable support without the complications associated with synthetic mesh. Unlike outdated or poorly executed tissue techniques of the past, such as the corrupted Bassini repair, Dr. Kang’s technique is anatomically precise, biomechanically balanced, and has demonstrated recurrence rates of less than 1%, with almost no reports of chronic pain.
Dr. Kang has successfully repaired all hernia types using this method, including indirect, direct, femoral, and large or recurrent cases—some of which were previously treated with mesh and had failed. His approach respects the body’s natural architecture and healing response, promoting proper collagen remodeling and avoiding the stiff, unidirectional scar tissue often produced by mesh implantation.
One of the most common criticisms of tissue-only repairs is the fear of recurrence, especially in patients who are active, overweight, or lifting heavy weights. But in Dr. Kang’s extensive experience, these concerns are largely exaggerated and often not grounded in evidence. His data shows that with proper surgical technique, recurrence remains extremely low even in high-risk or physically demanding individuals. In fact, many of the assumptions about natural tissue repair limitations come from flawed, tension-based versions of the Bassini technique or early 20th-century methods—not from modernized, biologically aware techniques like Kang’s. Similarly, post-operative weight restrictions often imposed after mesh surgeries are not required after successful tissue-based repairs. Patients are gradually returned to full strength, movement, and activity with minimal fear of reinjury.
Despite the superiority of this technique in many respects, it remains virtually unknown and unavailable in the U.S. Why? Because the American medical system continues to prioritize surgical efficiency, insurance compatibility, and standardized training over individualized, biologically harmonious care. Most surgeons are never trained in advanced tissue-only techniques, and the financial model incentivizes the use of pre-packaged mesh kits that simplify and speed up operations, even if it means worse outcomes for some patients.
This is not just a surgical debate—it’s a matter of patient rights. Every patient deserves to know all available options, especially one as effective and safe as Dr. Kang’s. To deny access to this method due to institutional inertia or economic convenience is irresponsible and arguably unethical. Mesh should not be the only accepted standard. Natural tissue repair, when done properly, deserves equal recognition, availability, and insurance support.
Imagine a world where patients are no longer sentenced to a lifetime of complications from synthetic materials, and where surgical excellence is measured not just in speed, but in long-term healing and restored quality of life. That world exists in places like Dr. Kang’s clinic in South Korea—and it’s time we bring it to the West.
Let patients choose. Let surgeons learn. Let truth speak louder than convenience. The future of hernia surgery should be grounded in science, shaped by experience, and above all, guided by what serves the patient best.
Authors Note: I had my repair done by Dr. Kang a few years ago. No issues. I turned 50 last month, started weight lifting seriously again about 7 months ago, and am fitter and healthier than ever. Lost 50lbs over the last 7 months using the Prolon product and working out in general. If anyone is considering a repair, making the trip to South Korea is easier and less expensive than you would think!
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4 Replies
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The Shouldice technique is described as a well-established, open, mesh-free repair with consistently low recurrence rates (around 1%) in experienced hands, particularly at dedicated centers like the Shouldice Hospital in Canada. It involves a multi-layered suture repair using the patient’s own tissue.
The Marcy repair, originally described by Henry Marcy, focuses on high ligation of the hernia sac and narrowing of the internal inguinal ring. It has been modified over time, particularly for use in children. Because hernias are not only a problem of the adult population.
Some sources suggest that the Shouldice technique, in experienced hands, has excellent results and is considered a gold standard for non-mesh repair.
One source mentions a modification of the Marcy operation that aims to improve the reconstitution of the inguinal shutter action and is theoretically superior to the classic Marcy operation.
For pediatric inguinal hernia repair, a modified Marcy repair is reported to be a safe and effective procedure with excellent outcomes and a low recurrence rate in a large single-center experience.
One of the provided articles states that for adults, mesh repairs are generally considered superior to non-mesh tissue-suture repairs due to lower recurrence rates overall.
Therefore, based on this information, it is difficult to definitively say that Marcy’s technique is superior to the Shouldice technique overall.
The Shouldice technique has a long history and a strong track record of low recurrence rates when performed by experienced surgeons in specialized centers.
The Marcy technique and its modifications appear to be effective, especially in pediatric cases.
<div>Based on the information available, a direct comparison between Dr. Kang’s technique and the Shouldice technique reveals the following.</div>
Similarities:
Both Dr. Kang’s technique and the Shouldice technique are non-mesh, open surgical methods for inguinal hernia repair.
http://gibbeum.com/whykr/Why-and-What-Kang-Repair.php
Both aim to repair the hernia using the patient’s own tissue.
Dr. Kang’s repair for indirect hernias is described as similar to the technique described by Dr. Marcy in the past, but modified to avoid high recurrence rates. The Shouldice technique is also an evolution from older tissue repairs.
Differences and potential advantages of Dr. Kang’s technique (as described):
Minimally Invasive (relatively):
Dr. Kang’s technique utilizes a smaller skin incision (around 3-3.5 cm) compared to traditional tissue repairs. While larger than laparoscopic incisions, it is described as less invasive as it only damages superficial abdominal wall layers. The typical incision size for a Shouldice repair is not explicitly mentioned in the provided context.Surgical Approach: For indirect hernias, Dr. Kang’s technique focuses on directly closing the internal inguinal ring (the hernia hole) by stitching, without routinely fixing the Hesselbach triangle.
For direct hernias, it modifies older posterior wall repair methods (which include Shouldice) to minimize damage and strengthen the repair within the Hesselbach triangle. The scope of surgery for direct hernias is described as much smaller than in older posterior wall repairs like Shouldice.
The Shouldice technique involves opening the posterior wall (transversalis fascia) and a multi-layered repair, sewing four distinct anatomical layers together.
Operating Time: Dr. Kang’s repair is reported to have a shorter operating time (20-30 minutes) compared to open mesh repairs or traditional posterior wall repairs (at least 40 minutes). The operating time for the Shouldice technique is not specified in this context.
Anesthesia: Dr. Kang’s technique can be performed under local anesthesia, often with intravenous sedation. The type of anesthesia used for the Shouldice technique is not mentioned here.
Postoperative Course: Dr. Kang’s technique is associated with a potentially faster recovery, with same-day discharge possible in some cases, early return to walking, showering, and work, and no restrictions on physical activity after two weeks. The recovery timeline for the Shouldice technique is not detailed in the provided information.
Recurrence Rates: Dr. Kang’s center claims “almost no reoccurrence” by directly addressing the hernia hole. While the Shouldice technique has low recurrence rates in experienced hands (around 1%), a direct comparison of rigorously collected data is not available within this context.
Avoidance of Mesh: Both techniques avoid mesh, which Dr. Kang’s proponents highlight as an advantage, citing potential mesh-related complications.
Limitations:
The information about Dr. Kang’s technique is primarily from the website of a hospital offering this procedure. Independent, peer-reviewed studies comparing it directly to the Shouldice technique are not readily available within this context.
The “almost no reoccurrence” claim for Dr. Kang’s technique would need to be substantiated by large, independent studies with long-term follow-up.
In conclusion, based on the information provided, Dr. Kang’s technique appears to be a modified, potentially less invasive non-mesh repair with a focus on direct closure of the hernia defect and a faster recovery. It claims very low recurrence rates and advantages over traditional open repairs like Shouldice in terms of incision size, operating time, anesthesia options, and postoperative recovery. However, without independent comparative studies, it is not possible to definitively conclude that Dr. Kang’s technique is superior to the well-established Shouldice technique, which also boasts excellent results in specialized centers.
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This reply was modified 41 minutes ago by John Fortem.
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This reply was modified 39 minutes ago by John Fortem.
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This reply was modified 38 minutes ago by John Fortem.
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Sorry for having to repost this. The new forum
software is giving me a hard time, like having to chase away HTML div
tags and link preview boxes whenever I insert a link and go to the next
line.Based on the information available, a direct comparison between Dr. Kang’s technique and the Shouldice technique reveals the following.
Similarities:
Both Dr. Kang’s technique and the Shouldice technique are non-mesh, open surgical methods for inguinal hernia repair.
http://gibbeum.com/whykr/Why-and-What-Kang-Repair.php
Both aim to repair the hernia using the patient’s own tissue.
Dr. Kang’s repair for indirect hernias is described as similar to the technique described by Dr. Marcy in the past, but modified to avoid high recurrence rates. The Shouldice technique is also an evolution from older tissue repairs.
Differences and potential advantages of Dr. Kang’s technique (as described):
Minimally invasive (relatively): Dr. Kang’s technique utilizes a smaller skin incision (around 3-3.5 cm) compared to traditional tissue repairs. While larger than laparoscopic incisions, it is described as less invasive as it only damages superficial abdominal wall layers. The typical incision size for a Shouldice repair is not explicitly mentioned in the provided context.
Surgical approach: For indirect hernias, Dr. Kang’s technique focuses on directly closing the internal inguinal ring (the hernia hole) by stitching, without routinely fixing the Hesselbach triangle.
For direct hernias, it modifies older posterior wall repair methods (which include Shouldice) to minimize damage and strengthen the repair within the Hesselbach triangle. The scope of surgery for direct hernias is described as much smaller than in older posterior wall repairs like Shouldice.
The Shouldice technique involves opening the posterior wall (transversalis fascia) and a multi-layered repair, sewing four distinct anatomical layers together.
Operating time: Dr. Kang’s repair is reported to have a shorter operating time (20-30 minutes) compared to open mesh repairs or traditional posterior wall repairs (at least 40 minutes). The operating time for the Shouldice technique is not specified in this context.
Anesthesia: Dr. Kang’s technique can be performed under local anesthesia, often with intravenous sedation. The type of anesthesia used for the Shouldice technique is not mentioned here.
Postoperative course: Dr. Kang’s technique is associated with a potentially faster recovery, with same-day discharge possible in some cases, early return to walking, showering, and work, and no restrictions on physical activity after two weeks. The recovery timeline for the Shouldice technique is not detailed in the provided information.
Recurrence rates: Dr. Kang’s center claims “almost no reoccurrence” by directly addressing the hernia hole. While the Shouldice technique has low recurrence rates in experienced hands (around 1%), a direct comparison of rigorously collected data is not available within this context.
Avoidance of mesh: Both techniques avoid mesh, which Dr. Kang’s proponents highlight as an advantage, citing potential mesh-related complications.
Limitations:
The information about Dr. Kang’s technique is primarily from the website of a hospital offering this procedure. Independent, peer-reviewed studies comparing it directly to the Shouldice technique are not readily available within this context.
The “almost no reoccurrence” claim for Dr. Kang’s technique would need to be substantiated by large, independent studies with long-term follow-up.
In conclusion, based on the information provided, Dr. Kang’s technique appears to be a modified, potentially less invasive non-mesh repair with a focus on direct closure of the hernia defect and a faster recovery. It claims very low recurrence rates and advantages over traditional open repairs like Shouldice in terms of incision size, operating time, anesthesia options, and postoperative recovery. However, without independent comparative studies, it is not possible to definitively conclude that Dr. Kang’s technique is superior to the well-established Shouldice technique, which also boasts excellent results in specialized centers.
So the experience of the surgeon and a tailored approach are paramount in achieving successful outcomes for hernia repair, likely outweighing the inherent superiority of one specific technique over another in all cases. While different techniques have their theoretical advantages and disadvantages, the surgeon’s skill in selecting the right technique for the individual patient and performing it flawlessly is the most critical factor in achieving a successful and durable hernia repair.
So in a way… what you’re getting when you go for the Dr. Kang repair is… perhaps… Dr. Yoon Sik Kang’s skill and experience, first and foremost. I think. That’s another way to look at it. (I don’t ever see his full name written out, so I thought I would make a reference here.) He started out doing Bassini repairs as a general surgeon, in 1987 I think it’s said on the website. So he has seen it all by now, all types of repairs and many kinds of hernia cases. The second most important factor, I think, is going to a surgeon who specializes in hernia surgery. This goes hand in hand. A surgeon specializing in hernias will undoubtedly be a skilled and experienced surgeon for hernias, naturally. But you should probably not trust a hernia surgeon do brain surgery!
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This reply was modified 41 minutes ago by
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Mike M,
As John Fortem states, there are plenty of surgical options which tout excellent options. Your post seems very promotional with no data to back it up.
Every surgeon and every technique has recurrences and complications. My recommendation is that Dr Kang publish his data and share his surgical technique if he wishes to make claims of superiority in outcomes. From the little information we have, it seems Dr Kang’s procedure is a modified Marcy repair, which we know historically is not adequate for most inguinal hernia repairs.
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Well written. Thanks for this report. I agree with you on all points. As you know, these points apply to other medical conditions as well. I share your dream, and hate to be the pessimist here, but the world you envision feels very distant. It’s all about the money. Money, money, money. Must be funny. In the rich man’s world. Money corrupts!
I wonder if anyone in Europe knows the Dr. Kang technique? I had my hernia repaired using a modified Shouldice technique, where the surgeon used the Prolane sutures you already mentioned, as opposed to steel sutures used in the original Shouldice. For some context, I had my hernia for almost 10 years, until it no longer was asymptomatic. Similar to you, I also had to go to another country to have it done my way, instead of the standard Lichtenstein with mesh – the patch him up and call in the next technique. It’s been about 6 years now since the surgery and I have not had a recurrence, even though I’m mildly overweight, and I was overweight when I had the surgery too.
Congratulations on a successful hernia repair! Also, congratulations on loosing those extra pounds and getting into better shape. I know I need to do the same, but it’s so easy to gain weight and so hard to loose. I hear maintaining a weight loss is even harder. I wouldn’t know, because I have maintained the same weight for the past 15 years or so, but on the wrong side of the scale.
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