Tension-free inguinal hernia repair in "one-day surgery". Experience of 1091 cases.

Background/aims: In recent years new techniques to repair inguinal hernia have evolved in order to reduce recurrence rate and the overall costs of treatment of this pathology. This paper analyses our experience in verifying the theoretical advantages of the "tension-free" technique, after six years of this surgical practice.

Methodology: We describe the experience of 1091 "tension-free" hernia repairs with open placement of a mesh in 1034 patients, under local anesthesia with a "one-day surgery" regimen; these patients were observed during the period 1994 to 1999 at the Surgical Unit of Catholic University of Rome. The patients were between American Society of Anesthesia Status I to IV. Eight hundred patients underwent a mean follow-up of 29.7 months (range: 4-72) to evaluate the occurrence of late complications and recurrences.

Results: No mortality or major intraoperative complications was observed. The only minor intraoperative or postoperative complications encountered were easily managed. Early pain disappearance, fast convalescence and rapid resumption of working activity were observed. Six recurrences occurred in the patients undergoing follow-up (0.75% recurrence rate).

Conclusions: Our data confirm the safety, rapidity, and reproducibility of the "tension-free" technique under local anesthesia performed with a "one-day surgery" regimen for inguinal hernia repair. These characteristics explain the diffusion of this surgical procedure with reduction of social costs.