Top

Hernia

Published in:

01-06-2015 | Original Article

Inguinal hernia repair outcomes that utilized the modified Kugel patch without the optional onlay patch: a case series of 163 consecutive patients

Authors: H.-C. Chiang, P.-H. Chen, Y.-L. Chen, M.-Y. Yan, C.-C. Chen, J. Lin, P.-F. Wang, H.-J. Shih

Published in: Hernia | Issue 3/2015

Abstract

Purpose

The purpose of this study was to evaluate the efficacy and safety of the anterior Kugel herniorrhaphy approach when the onlay patch is omitted.

Methods

The study population comprised patients who underwent anterior Kugel herniorrhaphy without the onlay patch from 1 May 2009, to 31 June 2012. The onlay patch was omitted if the posterior wall defect did not exceed the inner Posiflex^® ring diameter. After reviewing the clinical follow-up records and conducting telephone interviews, the postoperative results were recorded and analyzed.

Results

A total of 163 patients underwent 175 hernia repairs. One patient developed recurrence after undergoing our herniorrhaphy method. The most common postoperative complaints were mild soreness, indescribable discomfort, and foreign body sensations (11 patients). The mean operative time and hospital stay were 67 min and 2 days, respectively. More serious complications included one scrotal hematoma, one hydrocele, and one wound infection that resulted in epididymitis.

Conclusions

The onlay patch can be omitted with low recurrence and complication rates if the posterior wall defects do not exceed the inner Posiflex^® ring diameter.

Read RC (2009) Herniology: past, present, and future. Hernia J Hernias Abdom Wall Surg 13(6):577–580. doi:10.1007/s10029-009-0582-2 CrossRef

Amid PK (2003) The Lichtenstein repair in 2002: an overview of causes of recurrence after Lichtenstein tension-free hernioplasty. Hernia J Hernias Abdom Wall Surg 7(1):13–16. doi:10.1007/s10029-002-0088-7

Kugel RD (1999) Minimally invasive, nonlaparoscopic, preperitoneal, and sutureless, inguinal herniorrhaphy. Am J Surg 178(4):298–302CrossRefPubMed

Zhou X (2013) Comparison of the posterior approach and anterior approach for a Kugel repair of treatment of inguinal hernias. Surg Today 43(4):403–407. doi:10.1007/s00595-012-0258-x CrossRefPubMed

Reddy KM, Humphreys W, Chew A, Toouli J (2005) Inguinal hernia repair with the Kugel patch. ANZ J Surg 75(1–2):43–47. doi:10.1111/j.1445-2197.2005.03290.x CrossRefPubMed

Schroder DM, Lloyd LR, Boccaccio JE, Wesen CA (2004) Inguinal hernia recurrence following preperitoneal Kugel patch repair. Am Surg 70(2):132–136 discussion 136PubMed

Li J, Zhang Y, Hu H, Tang W (2008) Early experience of performing a modified Kugel hernia repair with local anesthesia. Surg Today 38(7):603–608. doi:10.1007/s00595-007-3681-7 CrossRefPubMed

Usher FC, Wallace SA (1958) Tissue reaction to plastics; a comparison of nylon, orlon, dacron, teflon, and marlex. AMA Arch Surg 76(6):997–999CrossRefPubMed

Uzzo RG, Lemack GE, Morrissey KP, Goldstein M (1999) The effects of mesh bioprosthesis on the spermatic cord structures: a preliminary report in a canine model. J Urol 161(4):1344–1349CrossRefPubMed

10.

Shin D, Lipshultz LI, Goldstein M, Barme GA, Fuchs EF, Nagler HM, McCallum SW, Niederberger CS, Schoor RA, Brugh VM 3rd, Honig SC (2005) Herniorrhaphy with polypropylene mesh causing inguinal vasal obstruction: a preventable cause of obstructive azoospermia. Ann Surg 241(4):553–558CrossRefPubMedCentralPubMed

11.

Kugel RD (2003) The Kugel repair for groin hernias. Surg Clin North Am 83(5):1119–1139. doi:10.1016/S0039-6109(03)00123-3 CrossRefPubMed

12.

Van Nieuwenhove Y, Vansteenkiste F, Vierendeels T, Coenye K (2007) Open, preperitoneal hernia repair with the Kugel patch: a prospective, multicentre study of 450 repairs. Hernia J Hernias Abdom Wall Surg 11(1):9–13. doi:10.1007/s10029-006-0137-8 CrossRef

13.

Millikan KW, Cummings B, Doolas A (2003) The Millikan modified mesh-plug hernioplasty. Arch Surg 138(5):525–529. doi:10.1001/archsurg.138.5.525 discussion 529–530CrossRefPubMed

14.

Lau H, Patil NG, Yuen WK, Lee F (2002) Learning curve for unilateral endoscopic totally extraperitoneal (TEP) inguinal hernioplasty. Surg Endosc 16(12):1724–1728. doi:10.1007/s00464-001-8298-0 CrossRefPubMed

15.

Inaba T, Okinaga K, Fukushima R, Ikeda Y, Yamazaki E, Koide T, Horikawa M, Inoue T, Ogawa E (2012) Chronic pain and discomfort after inguinal hernia repair. Surg Today 42(9):825–829. doi:10.1007/s00595-012-0153-5 CrossRefPubMed

16.

Lichtenstein IL, Shulman AG, Amid PK, Montllor MM (1988) Cause and prevention of postherniorrhaphy neuralgia: a proposed protocol for treatment. Am J Surg 155(6):786–790CrossRefPubMed

17.

Kumar S, Wilson RG, Nixon SJ, Macintyre IM (2002) Chronic pain after laparoscopic and open mesh repair of groin hernia. Br J Surg 89(11):1476–1479. doi:10.1046/j.1365-2168.2002.02260.x CrossRefPubMed

18.

Cunningham J, Temple WJ, Mitchell P, Nixon JA, Preshaw RM, Hagen NA (1996) Cooperative hernia study. Pain in the postrepair patient. Ann Surg 224(5):598–602CrossRefPubMedCentralPubMed

19.

Hompes R, Vansteenkiste F, Pottel H, Devriendt D, Van Rooy F (2008) Chronic pain after Kugel inguinal hernia repair. Hernia J Hernias Abdom Wall Surg 12(2):127–132. doi:10.1007/s10029-007-0295-3 CrossRef

20.

Maillart JF, Vantournhoudt P, Piret-Gerard G, Farghadani H, Mauel E (2011) Transinguinal preperitoneal groin hernia repair using a preperitoneal mesh preformed with a permanent memory ring: a good alternative to Lichtenstein’s technique. Hernia J Hernias Abdom Wall Surg 15(3):289–295. doi:10.1007/s10029-010-0778-5 CrossRef

21.

Koning GG, Koole D, de Jongh MA, de Schipper JP, Verhofstad MH, Oostvogel HJ, Vriens PW (2011) The transinguinal preperitoneal hernia correction vs Lichtenstein’s technique; is TIPP top? Hernia J Hernias Abdom Wall Surg 15(1):19–22. doi:10.1007/s10029-010-0744-2 CrossRef

22.

Kehlet H, Roumen RM, Reinpold W, Miserez M (2013) Invited commentary: persistent pain after inguinal hernia repair: what do we know and what do we need to know? Hernia J Hernias Abdom Wall Surg 17(3):293–297. doi:10.1007/s10029-013-1109-4 CrossRef

23.

LeBlanc KE, LeBlanc LL, LeBlanc KA (2013) Inguinal hernias: diagnosis and management. Am Fam Physician 87(12):844–848PubMed

Title: Inguinal hernia repair outcomes that utilized the modified Kugel patch without the optional onlay patch: a case series of 163 consecutive patients
Authors: H.-C. Chiang
P.-H. Chen
Y.-L. Chen
M.-Y. Yan
C.-C. Chen
J. Lin
P.-F. Wang
H.-J. Shih
Publication date: 01-06-2015
Publisher: Springer Paris
Published in: Hernia / Issue 3/2015
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-014-1297-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Inguinal hernia repair outcomes that utilized the modified Kugel patch without the optional onlay patch: a case series of 163 consecutive patients

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 3/2015

Laparoscopic benefits to rare hernias

Meta-analysis and systematic review of laparoscopic versus open mesh repair for elective incisional hernia

A rare case of a groin hernia: the Hesselbach’s hernia

Primary prevascular and retropsoas hernias: incidence of rare abdominal wall hernias

Description of robotically assisted single-site transabdominal preperitoneal (RASS-TAPP) inguinal hernia repair and presentation of clinical outcomes

Meta-analysis and review of prospective randomized trials comparing laparoscopic and Lichtenstein techniques in recurrent inguinal hernia repair