LAPAROSCOPIC REPAIR OF RECURRENT HERNIA

BACKGROUND: Failure rates for recurrent hernioplastics vary from 3% to 30%. To help explain this high incidence of recurrence, we reviewed o ur 4-year experience using a laparoscopic approach and analyzed the ch aracteristics of the recurrent hernias repaired. METHOD: One hundred f ifty-two patients with 173 recurrent hernias and 942 patients with 1,2 30 primary hernias were laparoscopically repaired using either a trans abdominal preperitoneal or a totally extraperitoneal laparoscopic appr oach. RESULTS: With a median follow-up of 24 months, one recurrence de veloped in the recurrent and four in the primary group. The incidence of bilateral disease (80% versus 46%), and the complexity of the herni as repaired (28% versus 14%) were significantly increased in the recur rent patients. CONCLUSION: The importance of intrinsic weakness and mi ssed hernias as factors that contribute to the failure of recurrent he rnioplasties was supported by our findings. The low early failure rate of our laparoscopic approach suggested that this technique may help i n eliminating these causes of failure. (C) 1996 by Excerpta Medica, In c.