Total extraperitoneal hernia repair in patients with previous lower abdominal surgery

Many surgeons feel total extraperitoneal (TEP) hernia repair is contraindic ated in patients with previous lower abdominal surgery. We have utilized th e TEP approach since 1993 for these patients. We have extracted two groups from our experience with TEP in patients with previous lower abdominal surg ery. The first group consists of 42 patit:nts in our first two years of exp erience, 1993-1994. The second group of 125 patients, who underwent surgery during 1996-1999, is taken from our most recent 1000 TEP procedures. Our d ata demonstrates that low rates of complications and recurrence can be achi eved in patients with: prior surgery. After the learning curve has been pas sed, we found that our results were remarkably improved in these patients. Overall 4 major complications and one recurrence occurred in all 167 patien ts and all of these were in the first group, 1993-1994. Laparoscopic TEP he rnia repair can be performed safely and effecively in patients with previou s lower abdominal surgery.