Background: To understand how laparoscopic hernioplasty prevents early
recurrence of hernia, we reviewed our first 1,000 patients, We analyz
ed the patients by age, sex, and hernia type and by whether their hern
ia was primary or recurrent. Methods: The 1,000 patients had 1,336 her
nias repaired by the transabdominal preperitoneal or the totally extra
peritoneal approach. One thousand one hundred seventy-three hernias we
re primary and 163 were recurrent. The type of hernia found varied wit
h thp patient's age (p < 0.001), and with whether the hernia was prima
ry or recurrent (p < 0.001); 14% of primary and 27% of recurrent herni
as were complex, a surprisingly high incidence compared to historical
controls, Results: With a median follow-up of 2 years, five hernias ha
ve recurred and all were due to technical errors. Conclusions: The lap
aroscopic repair's success may partially be due to its unique ability
to diagnose previously overlooked complex elements. The defects are re
paired without creating tension and the groin is reinforced with mesh,
eliminating inherent weakness.