BMI ≥35

life expectancy of \<3 years

strangulated hernia

urologic disorder and/or previous urologic surgery in the testicular area (with the exception of prostate surgery)

active abdominal surgical condition such as bowel obstruction or perforation

local or systemic infection or peritonitis

known disease that impairs wound healing

anti-platelet therapy (other than aspirin) for \>7 days preceding the surgical procedure

previous ipsilateral groin incision

receiving immunosuppressive therapy and/or has undergone radiation therapy to the affected groin area

uncontrolled insulin-dependent diabetic with Hgb1Ac greater than 8

advanced cirrhosis with Child-Turcott Class of C or higher

severe COPD requiring home oxygen

diagnosed with chronic pain syndrome or is undergoing treatment for pain management

candidate for another major surgical procedure with the inguinal hernia repair

enrolled in another investigational study that may confound the results of this study

known drug abuser

on anti-psychotic medications

Worker's Compensation case

Study of Surgical Mesh for Inguinal Hernia Repair