title: Minimally invasive, nonlaparoscopic, preperitoneal, and sutureless, inguinal herniorrhaphy.
abstract: BACKGROUND
  Recent efforts at development of an ideal method for herniorrhaphy have resulted in a number of tremendous advances. The keen interest in hernia surgery and newer methods of repair, however, suggests that most surgeons are not fully satisfied with the methods currently available.
  
  
  METHODS
  This repair involves a preperitoneal approach accomplished under regional or local anesthesia, with limited instrumentation and expense. It is performed in both a tension-free and sutureless fashion through a very small incision. It is effective in the treatment of primary and recurrent direct and indirect hernias as well as femoral hernias using the same approach in each case.
  
  
  RESULTS
  With 808 hernia repairs performed over a 54-month period of time there have been only five recurrences identified. There were only two wound infections. No specific restrictions with regard to activity were placed on these patients after surgery. In almost all cases the patients were able to return to regular activities, including work, within a few days after surgery.
  
  
  CONCLUSIONS
  The results with this procedure suggest that it may be a more effective method of hernia repair when cost, ease of performance, and rapid recovery are important considerations.
authors.affiliation: Hernia Treatment Center Northwest, Olympia, Washington 98506, USA.
authors.forename: R D
authors.initials: RD
authors.lastname: Kugel
mesh_terms: D013505:Digestive System Surgical Procedures / Q000379:methods*; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D012008:Recurrence; D013526:Surgical Mesh