Ann Surg Treat Res.  2014 Dec;87(6):325-330. 10.4174/astr.2014.87.6.325.

Tumescent local anesthetic technique for inguinal hernia repairs

• Chyung JW
• Shin DG
• Kwon Y
• Cho DH
• Lee KB
• Park SS
• Yoon J
• Jang YS

• KMID: 2167089
• DOI: http://doi.org/10.4174/astr.2014.87.6.325

Abstract

PURPOSE
We evaluated the adequacy and feasibility of a tumescent solution containing lidocaine and bupivacaine for inguinal hernia repairs.
METHODS
The medical records of 146 consecutive inguinal hernia patients with 157 hernia repairs using the tumescent local anesthesia technique performed by a single surgeon between September 2009 and December 2013 were retrospectively reviewed.
RESULTS
The mean operation time (+/-standard deviation) and hospital stay were 64.5 +/- 17.6 minutes and 2.7 +/- 1.5 days. The postoperative complication rate was 17.8%. There were four cases of recurrences (2.5%) at a mean follow-up of 24 +/- 14 months.
CONCLUSION
Our results suggest that local anesthesia with the tumescent technique is an effective and safe modality for inguinal hernia repairs.

Keyword

Inguinal hernia; Tumescent local anesthesia; Safety

MeSH Terms

Anesthesia, Local
Bupivacaine
Follow-Up Studies
Hernia, Inguinal*
Herniorrhaphy
Humans
Length of Stay
Lidocaine
Medical Records
Postoperative Complications
Recurrence
Retrospective Studies
Bupivacaine
Lidocaine

Reference

1. Farquharson EL. Early ambulation; with special reference to herniorrhaphy as an outpatient procedure. Lancet. 1955; 269:517–519.

2. Gultekin FA, Kurukahvecioglu O, Karamercan A, Ege B, Ersoy E, Tatlicioglu E. A prospective comparison of local and spinal anesthesia for inguinal hernia repair. Hernia. 2007; 11:153–156.

3. Sanjay P, Woodward A. Inguinal hernia repair: local or general anaesthesia? Ann R Coll Surg Engl. 2007; 89:497–503.

4. Amid PK, Shulman AG, Lichtenstein IL. Local anesthesia for inguinal hernia repair step-by-step procedure. Ann Surg. 1994; 220:735–737.

5. Welsh DR, Alexander MA. The Shouldice repair. Surg Clin North Am. 1993; 73:451–469.

6. Kark AE, Kurzer M, Waters KJ. Tension-free mesh hernia repair: review of 1098 cases using local anaesthesia in a day unit. Ann R Coll Surg Engl. 1995; 77:299–304.

7. Yang JH, Park SS, Yoon J, Kim IM. A comparison of three methods of hernioplasty for adult inguinal hernia: Bassini repair versus lichtenstein repair versus Mesh-Plug repair. J Korean Surg Soc. 2004; 67:314–319.

8. Min HS, Shin DW, Kim ID, Kim KH, Suh BS, Kim SW, et al. Comparison between lichtenstein and prolene hernia system (PHS) in anterior tension-free, inguinal & femoral hernioplasty. J Korean Surg Soc. 2006; 71:39–42.

9. Lee TG, Park JS, Lee SI, Choi YS, Park DJ, Han HS, et al. The state of patient satisfaction after hernioplasty on an ambulatory basis. J Korean Surg Soc. 2007; 73:53–59.

10. Kim HJ, Ryu HS, Hur YH, Kim JC, Kim SK, Park CY. Inguinal hernia repair under local anesthesia in octogenarians. J Korean Surg Soc. 2009; 77:338–343.

11. Lee WI, Kim HS, Ryu BY, Kim HK, Lee JW, Choi YH, et al. Clinical analysis of inguinal hernia in adult using prolene hernia system. J Korean Surg Soc. 2010; 79:137–142.

12. Callesen T, Bech K, Kehlet H. The feasibility, safety and cost of infiltration anaesthesia for hernia repair. Hvidovre Hospital Hernia Group. Anaesthesia. 1998; 53:31–35.

13. Lawrence K, McWhinnie D, Goodwin A, Gray A, Gordon J, Storie J, et al. An economic evaluation of laparoscopic versus open inguinal hernia repair. J Public Health Med. 1996; 18:41–48.

14. Nyhus LM, Condon RE. Hernia. 3rd ed. Philadelphia: Lippincott;1989.

15. Narita M, Sakano S, Okamoto S, Uemoto S, Yamamoto M. Tumescent local anesthesia in inguinal herniorrhaphy with a PROLENE hernia system: original technique and results. Am J Surg. 2009; 198:e27–e31.

16. Amid PK, Shulman AG, Lichtenstein IL. A five-step technique for local anesthesia in inguinal hernia repair. Chirurg. 1994; 65:388–390.

17. Kulacoglu H, Ergul Z, Esmer AF, Sen T, Akkaya T, Elhan A. Percutaneous ilioinguinal-iliohypogastric nerve block or step-by-step local infiltration anesthesia for inguinal hernia repair: what cadaveric dissection says. J Korean Surg Soc. 2011; 81:408–413.

18. Gultekin FA, Kurukahvecioglu O, Karamercan A, Ege B, Ersoy E, Tatlicioglu E. A prospective comparison of local and spinal anesthesia for inguinal hernia repair. Hernia. 2007; 11:153–156.

19. Fenoglio ME, Bermas HR, Haun WE, Moore JT. Inguinal hernia repair: results using an open preperitoneal approach. Hernia. 2005; 9:160–161.

20. Nordin P, Zetterstrom H, Carlsson P, Nilsson E. Cost-effectiveness analysis of local, regional and general anaesthesia for inguinal hernia repair using data from a randomized clinical trial. Br J Surg. 2007; 94:500–505.

21. Liem MS, Halsema JA, van der, Schrijvers AJ, van Vroonhoven TJ. Cost-effectiveness of extraperitoneal laparoscopic inguinal hernia repair: a randomized comparison with conventional herniorrhaphy. Coala trial group. Ann Surg. 1997; 226:668–675.

22. Amid PK, Shulman AG, Lichtenstein IL. Simultaneous repair of bilateral inguinal hernias under local anesthesia. Ann Surg. 1996; 223:249–252.

23. Kehlet H, Bay-Nielsen M. Local anaesthesia as a risk factor for recurrence after groin hernia repair. Hernia. 2008; 12:507–509.