Early experience of performing a modified Kugel hernia repair with local anesthesia

Purpose. We report our results with the modified Kugel hernia repair, a relatively new and minimally invasive open technique offering the advantages of preperitoneal repair without the need for general anesthesia. Methods. We performed 42 inguinal or femoral hernias (44 sides), including incarcerated femoral hernias, using this modified technique, giving the patient local anesthesia with very little sedation. We describe the operative techniques used and the postoperative complications encountered. Results. The mean operation time was 55 +/- 26 min and the mean hospital stay was 4 days (2-8 days). There were no major postoperative complications and patients were followed up for a mean period of 1 year. Only one patient complained of mild discomfort in the inguinal area after 6 months. There was no incidence of recurrence. Conclusion. The modified Kugel hernia repair is easy to learn, and it seems to have a lower recurrence rate and fewer postoperative complications than conventional types of hernia repair. Moreover, it offers the advantage of allowing the patient to undergo preperitoneal inguinal hernia repair under local anesthesia, which is especially beneficial for older patients with preoperative morbidity.