LAPAROSCOPIC REPAIR OF RECURRENT INGUINAL-HERNIAS

BACKGROUND: Repair of recurrent inguinal hernias is associated with re currence rates as high as 30% and complication rates higher than for p rimary hernias. PATIENTS AND METHODS: In a prospective study, results were evaluated after laparoscopic transabdominal preperitoneal hernia repair in 192 patients with 200 recurrent inguinal hernias, A total of 132 hernia repairs followed one previous repair, 41 followed two repa irs, 17 followed three repairs, 6 followed four, 3 followed five, and 1 followed six previous repairs. The surgical technique is described. RESULTS: Follow-up ranged from 9 to 31 months (mean 18.4). Twelve pati ents (6%) had groin seromas or hematomas; 3 (1.5%) had transient thigh numbness. One patient (0.5%) underwent laparoscopy a second time beca use of a large hematoma. In 1 patient(0.5%), a staple an the n. cutane us femoris lateralis was removed laparoscopically. Patients described postoperative pain as being much less severe compared with their previ ous operation. Of the total group, 76% of patients were able to return to work within 2 weeks of surgery. One recurrence (0.5) occurred afte r 6 months because of too small a prosthetic mesh. CONCLUSIONS: This l aparoscopic technique can be applied to recurrent hernias, even in dif ficult cases, with low morbidity rates. Recurrence rates as low as for laparoscopic repair of primary hernias can be expected.