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Open, preperitoneal hernia repair with the Kugel patch: a prospective, multicentre study of 450 repairs
Y Van Nieuwenhove1, F Vansteenkiste, T Vierendeels
1Department of Surgery, Academisch Ziekenhuis-Vrije Universiteit Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium. hlkvney@az.vub.ac.be
Background:
The Kugel patch inguinal hernia repair is a relatively new, open, minimally invasive procedure using a preperitoneal approach.
Method:
Prospective multicentre case series of 450 consecutive Kugel patch repairs. Recurrence rates and persistent inguinal pain after at least 1 year as well as short-term outcomes were studied.
Results:
After a follow-up of 18 months, eight recurrences (1.9%) were found, and persisting inguinal pain was reported in 15 patients (3.5%). The mean operation time and hospital stay were 20 +/- 9 min and 19 +/- 1.3 h respectively. Less than 1% of patients planned for an ambulatory treatment needed prolonged hospitalisation. Analgesics were used for 3 +/- 2 days. Paracetamol was the only painkiller used in 69% of patients, and 13% did not take any painkiller at all. Half of all patients returned to their daily activities after 9 days and half of the employed patients returned to work after 14 days.
Conclusion:
The Kugel patch repair is a quick technique with a low recurrence rate and good patient comfort. It offers the advantages of a preperitoneal inguinal hernia repair without the need for general anaesthesia or expensive laparoscopic equipment.