The technical problems, early complications and short-term results of a tension-free method of 1098 inguinal hernia repairs in 1017 patients have been assessed. The operation was conducted under local anaesthesia, and the inguinal canal floor was reinforced by a polypropylene mesh. Patients were discharged home the same day. There was no mortality, no urinary complications and one case of venous thrombosis. There was one recurrence after a primary hernia repair and two patients have developed recurrences after repair of a recurrent hernia. The overall sepsis rate was 0.9% and 1% of patients had persistent neuralgia. No prosthesis required removal. In all, 49.6% of office workers returned to work in 1 week or less and 61% of manual workers in 2 weeks or less. The major advantages of the tension-free mesh repair under local anaesthesia are simplicity, substantial cost savings and very low rates of complications.
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