Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May 26;25(1):229.
doi: 10.1186/s12893-025-02931-8.

The feasibility and safety of ventral hernia repairs under local anaesthesia: a systematic review

Sarah Michael #  1 , Afifa Naseer #  2 , Munir Tarazi  3 , Bhamini Vadhwana  4
Affiliations

The feasibility and safety of ventral hernia repairs under local anaesthesia: a systematic review

Sarah Michael et al. BMC Surg. .

Abstract

Background: Ventral hernias represent a significant global healthcare burden. Repair under local anaesthesia (LA) provides benefits to patients, hospitals and economies. While inguinal hernia repair under LA has been established, this has not translated to other abdominal wall hernias. This systematic review evaluates the feasibility, safety, and efficacy of performing these repairs under LA.

Methods: A systematic review was conducted using OVID® EMBASE and MEDLINE to review articles published between 1966 and 2023. Thirty-three papers were included examining variables such as type of hernia, complications, cost-effectiveness, LA used and length of stay. All papers were quality assessed using the ROBINS-I tool. Papers assessing inguinal hernias were excluded.

Results: 13,491 patients underwent ventral hernia repair under LA. Complication rates for LA repairs are low, with wound infections and hematomas ranging from 0.3 to 2%. Recurrence rates were also low (0.3-2.5%). Early mobilisation and same-day discharge were notable benefits, with over 97% of patients ambulatory within hours. Postoperative pain was minimal, contributing to high patient satisfaction rates (90-97%). LA repairs proved especially beneficial for high-risk groups, including elderly and frail patients. However, these findings were only seen in hernia defects less than 5 cm. Heterogeneity among study populations, small sample sizes, and lack of standardisation in LA administration were noted.

Conclusion: This review supports the broader implementation of LA for ventral hernia repairs in small defects (< 5 cm), demonstrating its safety, feasibility, and patient acceptability. Careful patient selection for standardisation of best practices for LA hernia repairs offers the potential for significant cost-savings with overall favourable outcomes.

Keywords: Hernia; Local anaesthetic; Ventral hernia.

PubMed Disclaimer

Conflict of interest statement

Declarations. Consent for publication: Not applicable. Human ethics and consent to participate declaration: Not applicable- no human participants. Competing interests: The authors declare no competing interests. Consent to participate declaration: Not applicable as systematic review and no human participants. Conflict of interest: The authors report no conflicts of interests or financial declarations.

Figures

Fig. 1
Fig. 1
PRISMA flowchart detailing article selection
Fig. 2
Fig. 2
ROBINS-I tool for quality assessment of articles investigating the benefit of ventral hernia repair under local anaesthetic
See this image and copyright information in PMC

References

    1. Pawlak M, Tulloh B, de Beaux A. Current trends in hernia surgery in NHS England. Ann R Coll Surg Engl. 2020;102:25–7. 10.1308/rcsann.2019.0118. - PMC - PubMed
    1. Kingsnorth A, Blanc KA. Management of abdominal hernias.-3-d edition. 2003.
    1. Argo M, Favela J, Phung T, et al. Local VS. other forms of anesthesia for open inguinal hernia repair: A meta-analysis of randomized controlled trials. Am J Surg. 2019;218:1008–15. 10.1016/j.amjsurg.2019.06.024. - PubMed
    1. Reece-Smith AM, Maggio AQ, Tang TY, et al. Local anaesthetic vs. general anaesthetic for inguinal hernia repair: systematic review and meta-analysis. Int J Clin Pract. 2009;63:1739–42. 10.1111/j.1742-1241.2009.02131.x. - PubMed
    1. Prakash D, Heskin L, Doherty S, et al. Local anaesthesia versus spinal anaesthesia in inguinal hernia repair: A systematic review and meta-analysis. Surgeon. 2017;15:47–57. 10.1016/j.surge.2016.01.001. - PubMed

Publication types

LinkOut - more resources