Document Detail

Management of recurrent inguinal hernias after total extraperitoneal (TEP) herniorrhaphies.
MedLine Citation:
PMID:  19670974     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: The laparoscopic repair offers clear advantages in recurrent inguinal hernias after open herniorrhaphy. Less clear is the role of laparoscopy for recurrences after previous laparoscopic inguinal herniorrhaphies. In this paper, we present our experience with both laparoscopic and open inguinal hernia repair of laparoscopic recurrences. METHODS: All patients who had undergone repair of recurrences after previous laparoscopic hernia repair from July 2004 to July 2007 were included in this study. Charts were reviewed for all these patients. RESULTS: Six patients were diagnosed with 7 recurrent inguinal hernias after laparoscopic repairs. All the initial laparoscopic repairs, except for one, were total preperitoneal (TEP) with the placement of lightweight polypropylene mesh. The average time from the initial repair to the diagnosis of recurrence was 20 months (range 3-84). Four of the 7 recurrences were treated with a laparoscopic approach. The other three recurrences were repaired in an open fashion as per the preoperative plan. In 2 of the laparoscopic cases, the peritoneal flap was not able to cover the mesh, so a tissue-separating mesh with fibrin sealant was utilized to cover the myopectineal orifice. No intra- or postoperative complications were recorded. There were no recurrences at an average follow-up of 14 months (range, 11-17). CONCLUSIONS: Laparoscopic repair can be offered to those patients with a recurrence after a previous laparoscopic repair. Further studies comparing laparoscopic repair versus open repair of recurrences after laparoscopic inguinal hernia repair will be helpful in defining the best approach when encountering these recurrences.
Emanuele Lo Menzo; Seth A Spector; Alberto Iglesias; Jose M Martinez; Jorge Huaco; Vincent DeGennaro; Atul K Madan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of laparoendoscopic & advanced surgical techniques. Part A     Volume:  19     ISSN:  1092-6429     ISO Abbreviation:  J Laparoendosc Adv Surg Tech A     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-08-12     Completed Date:  2009-10-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706293     Medline TA:  J Laparoendosc Adv Surg Tech A     Country:  United States    
Other Details:
Languages:  eng     Pagination:  475-8     Citation Subset:  IM    
Miami VA Healthcare System, University of Miami, Miller School of Medicine, 1201 NW 16th Street, Miami, FL 33125, USA.
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MeSH Terms
Cohort Studies
Hernia, Inguinal / etiology,  pathology,  surgery*
Middle Aged
Retrospective Studies
Surgical Flaps
Surgical Mesh
Suture Techniques
Treatment Outcome

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