Single-Surgeon Experience with 2,790 Consecutive Elective Groin Hernia Repairs Under Local Anesthesia: Outcomes and Technical Considerations

Phichai Phongmanjit

doi:10.64387/tjs.2026.275388

Authors

Phichai Phongmanjit Department of Surgery, School of Medicine, Mae Fal Luang University, Chiang Rai

DOI:

https://doi.org/10.64387/tjs.2026.275388

Keywords:

Groin hernia repair, Local anesthesia infiltration, One-day surgery (ODS)

Abstract

Objective: This study presents the author’s 34-year experience with groin hernia repair under local anesthesia, a technique adopted in 1989. It discusses the rationale, evolution, technical considerations, clinical benefits, and alignment with the 2023 International HerniaSurge Guidelines, which support local anesthesia in selected patients. This method is especially valuable for high-risk patients unsuitable for general or regional anesthesia.

Materials and Methods: This retrospective analysis draws from records from Chiangrai Prachanukroh Hospital. All procedures were performed or supervised by a single surgeon. Included were adult patients (≥ 18 years) undergoing elective groin hernia repair; cases with acute complications were excluded. Data collected included demographics, hernia type, repair technique, operative time, hospital stay, and complications. Ethical approvals were obtained.

Results: From September 1989 to September 2023, 2,790 groin hernia repairs were performed under local anesthesia. Most patients were male (97%), with indirect inguinal hernia being the most common (77.8%). A tension-free repair with a modified Lichtenstein technique was used in 76% of cases. Intraoperative assessment included voluntary patient straining to confirm the integrity of the repair. A one-day surgery (ODS) approach was applied in 91.4% of cases. The overall complication rate was 5.28%, and the recurrence rate was notably low at 0.71%.

Conclusion: Groin hernia repair under local anesthesia is a safe, effective, and cost-efficient option, well-suited for one-day surgery. With excellent outcomes and reduced inpatient resource use, this approach supports broader adoption in Thailand’s healthcare system. The author encourages wider use of local anesthesia in routine open groin hernia repairs.

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