• The PolySoft hernia patch with the ONSTEP technique would be presented as an option in the standard clinical pathway for surgical inguinal hernia repair.

  • Two published case series involving 698 and 80 patients have reported initial experience of using the PolySoft hernia patch with the accompanying ONSTEP surgical technique for inguinal hernia repair.

  • The authors of the larger of these studies compared their findings on duration of surgery with those from a separate study of another open total extraperitoneal approach hernia repair technique, suggesting that the duration was reduced.

  • Both studies recommended more extensive comparisons of hernia repair techniques over a longer follow‑up period to establish efficacy.

Adverse events and safety

  • Five types of complications were reported in both the identified studies. These included haematoma and residual pain. Initial use shows complication rates (of 0.7% and 7.5%) to be potentially lower than those of other open total extraperitoneal and Lichtenstein techniques.

Cost and resource use

  • The PolySoft hernia patch used with the ONSTEP technique has an NHS acquisition cost of £116.30 per box excluding VAT. Each repair needs 1 box. No evidence on cost and resource use was available.

Technical factors

  • The PolySoft hernia patch with the ONSTEP technique would be used within general surgery for inguinal hernia repair by surgeons with suitable training and experience.