The aim of this study is to examine the efficacy and safety of anterior preperitoneal Kugel patch repair in recurrent inguinal hernias after previous tension-free prosthetic repair and to assess its morbidity and recurrence rate.

Forty patients with recurrent inguinal hernia previously repaired by prosthetic materials were studied retrospectively between January 2006 and January 2016. The hernia types of the recurrence, operative time, complications and recurrence rate were recorded. Visual analogue scale (VAS) were used to record the incidence of chronic pain. All patients underwent transinguinal incision. By removing surrounding scar tissue, previous mesh or plug and cutting transversalis fascia, the Kugel patch was placed preperitoneally between transversalis fascia and peritoneum.

Mean operative time was 50 min (50-65 min). There were 8 minor peritoneum injury during operation. 3 patients had hematoma and 1 patient had seroma. After a mean of 24 months follow-up, chronic pain was improved remarkably from 77.5% preoperatively to 12.5% postoperatively, and no recurrence was detected.

Anterior preperitoneal Kugel patch repair is safe and effective in treatment of recurrent hernia after previous tension-free prosthesis repair, and it is especially suitable for patients with chronic pain following mesh or plug repair.