And, jumping into a propeller airplane, the two friends, along with Martin's wife, flew over 1,078 miles to Porterville for treatment.

"I heard Miles mention the procedure when he had his hernia," Martin said. "Miles had recommended Dr. Pandya and once I figured out insurance would cover it, we set it up."

Martin was evaluated by Dr. Pandya on Thursday, had the outpatient surgery on Friday, spent the weekend in the Sequoias, and planned to return to Washington Monday after his follow-up appointment.

Martin traveled to Porterville at the recommendation of his friend, Miles Erickson, who lives in the San Juan Islands in Washington.

Erickson had originally had a Bard Kugel hernia patch repair done by Dr. Robert Kugel, inventor of the method. But when a second hernia developed after Dr. Kugel had retired, Erickson searched the internet and found Dr. Pandya.

On Thursday, the two friends talked about the benefits of the surgery in Dr. Pandya's office.

"It was minimally invasive, was done under local anesthesia and I was able to walk away, not wheeled away in a wheelchair, after the procedure," Erickson said.

Dr. Pandya, who uses ultrasound equipment to see the hernia and has performed an approximate 600 to 700 procedures under local anesthesia, said he was not surprised when he received the call because Erickson had told him he would return and bring his friends.

"We feel very honored," Dr. Pandya said.

The procedure is outpatient and takes approximately 30 to 45 minutes to complete. The patch is inserted through a small incision, but all of it is done under local anesthesia.

Jeanette Aguilar, Dr. Pandya's medical assistant who runs the ultrasound equipment, knows about the procedure first hand. She had the procedure done by Dr. Pandya a month ago.

She had the procedure done just before the doctor was scheduled to take two weeks off and then used the time off to recuperate. But she did not need the full two weeks. She was back on her feet in a day.

In addition to using ultrasound for surgical procedures, Dr. Pandya said he has used the ultrasound for 5,000 to 7,000 examinations since the mid 1990s for conditions such as breast cancer and varicose veins.

"The side effects are not there and they can go right back to work," Dr. Pandya said. "The patch is applied from the inside."

And it is done without any anesthesia or hospital costs.

The procedure at the facility cost an approximate $3,000, compared to $15,000 at Sierra View District Hospital and $20,000 at Kaweah Delta Medical Center in Visalia, Martin said.

"It's all done right here, in our surgical center," said Ela Pandya, administrator of the Natraj Surgery Center in Porterville. "It's a full-fledge surgical center, complete with recovery room and everything."