LAPAROSCOPIC REPAIR OF RECURRENT HERNIAS

The purpose of this study was to evaluate the results of a laparoscopi c approach to recurrent inguinal hernia repair which dissected the ent ire inguinal floor and repaired all potential areas of recurrence with out producing tension. Both a transabdominal preperitoneal and a total ly extraperitoneal laparoscopic approach were utilized. Ninety recurre nt hernias were repaired in 81 patients. The patients had 26 indirect, 36 direct, and 26 pantaloon recurrent hernias of which eight had a fe moral component. In all but one patient the primary operations were op en anterior repairs. The median follow-up was 14 months, ranging from 1 to 28 months. Patients returned to normal activities in an average o f 1 week. The only recurrence observed was in the one patient whose pr imary repair was laparoscopic. When the entire inguinal floor of the r ecurrent hernia was redissected and buttressed with mesh, early recurr ence was eliminated and recovery was shortened.