Long-term results of laparoscopic repair (TAPP) of recurrent inguinal hernias

Inguinal hernia repair is the most frequently performed surgical operation. Recurrences represent an essential problem in surgery, and repair of recurrent hernia, due to the markedly changed anatomy, constitutes a very difficult and demanding procedure. The aim of the study was assessment of long-term results of laparoscopic inguinal herniorrhaphies performed in the 2nd Department of Surgery from 01.01.1997 to 31.12.2004. There were 112 patients operated on due to recurrent inguinal hernias within the study period. All of them were treated using the laparoscopic TAPP technique. 70.5% of them were operated on due to first recurrence of hernia; in the rest of the patients several hernioplasties (from 3 to 5) had already been performed. The vast majority of the patients were previously operated on using classic Bassini or Girard technique. Every patient included in the study was assessed during follow-up visits according to a questionnaire, with clinical examination performed by the surgeon who had operated on him. Mean hospital stay was 3.82 days. Median length of follow-up was 62.5 months (from 24 to 120 months). There were four re-recurrences (3.6%) noted within the first year after laparoscopic operation. Three of them occurred in patients who had undergone more than one previous herniorrhaphy. There were no secondary hernias noted in trocar sites. No serious long-term complications (including strangulation ileus) were found. Time for return to normal physical activity and to work was short (usually a few or a dozen days). There was no marked postoperative pain noted and the vast majority of patients required only oral analgesics for about a week. On the basis of the very low incidence of recurrences and complications the authors find laparoscopic repair to be the most suitable way to treat recurrent hernia.