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.
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Chiang, H. C., Chen, P. H., Chen, Y. L., Yan, M. Y., Chen, C. C., Lin, J., Wang, P. F., & Shih, H. J. (2015). Inguinal hernia repair outcomes that utilized the modified Kugel patch without the optional onlay patch: a case series of 163 consecutive patients. Hernia, 19(3), 437-442. https://doi.org/10.1007/s10029-014-1297-6