Recurrent inguinal hernia after local anaesthetic repair

A consecutive series of 227 inguinal hernias were repaired under local anaesthetic between 1976 and 1978 in the Oxford hospitals. A total of 187 of these operations was performed on a day-case basis. Data were available for analysis from 183 cases in whom there were 13 recurrences. The factor most strongly influencing the recurrence rate was the experience of a particular surgeon with the local anaesthetic technique. It was found that once 6 hernias had been repaired under local anaesthetic the chance of recurrence fell to a level of 2.5 per cent (which projects to 7.5 per cent at the end of 25 years). The recurrence rate for beginners (those who have repaired less than 6 hernias under local anaesthetic) was unacceptably high at 9.4 per cent (which projects to 28 per cent at the end of 25 years). Our recurrence rate was high in patients with a direct hernia in whom there were associated risk factors known to predispose to recurrence.