Breaking Barriers to Tension-Free Hernia Repair in Emerging Markets


Identify and address barriers to adoption of tension-free hernia repair techniques in China and emerging markets.  


A variety of technologically feasible, patentable ideas and recommendations to address unmet market needs and lay the foundation for new hernia-repair product development in these emerging markets.

About 96% of all hernias are inguinal. It is estimated that 20 million inguinal hernia repairs are performed globally every year, making this one of the most frequently performed general surgeries.

Worrell China partnered with Ethicon Inc. to identify barriers to adoption of existing tension-free hernia repair techniques by way of immersive research, videography, and clinical procedure observations — specifically in China and similar markets. With these insights, new product offerings were developed to help surgical teams meet the goals of the Lichtenstein, plug and patch, and preperitoneal techniques.

Qualitative field data and insights were synthesized using Worrell’s proprietary Censys™ tool, which enabled the project team to identify and focus on areas of opportunity with the greatest possibility to provide “customer delights.”

They then organized and led a series of highly productive and focused cross-functional ideation sessions in order to develop potential product solutions that addressed these specific unmet market needs. The most promising concepts were prototyped and tested by the Worrell China team through a series of qualitative, in-depth surgeon interviews.

Worrell China’s tailored process, initially intended to address a portfolio gap in China, created numerous technologically feasible and patentable ideas, while laying the foundation for Ethicon Inc.’s new multi-year product pipeline with emerging market and global implications. The key findings and recommendations that emerged from the ethnographic research are reiterated almost verbatim in Ethicon’s current product marketing literature.


The ULTRAPRO COMFORT PLUG™, the first and only macroporous, partially absorbable mesh plug that is now used for open inguinal hernia repair, emerged from the results of the strategic partnership between Worrell China and Ethicon. Worrell worked in close collaboration with Ethicon Research & Development in Germany and China, as well as Global Strategic Marketing, to bring the product to market.