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Updated: Jul 13, 2026
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Published on: September 11, 2021
Recurrence following endoscopic extraperitoneal inguinal hernioplasty
1Department of Surgery, University of Hong Kong Medical Center, Queen Mary Hospital, Pokfulam, Hong Kong SAR, China. hklauh@yahoo.com.hk
Summary
Recurrent inguinal hernias after endoscopic surgery (TEP) can indicate technical failure. Addressing herniated retroperitoneal fat during TEP can reduce recurrence rates.
Area of Science:
- General Surgery
- Minimally Invasive Surgery
Background:
- Recurrence rate is a critical metric for evaluating hernia surgery effectiveness.
- Endoscopic totally extraperitoneal inguinal hernioplasty (TEP) is a common surgical approach.
Purpose of the Study:
- To analyze recurrence rates following TEP.
- To identify causes of recurrence after TEP.
- To recommend modifications to the TEP procedure.
Main Methods:
- Retrospective review of six patients with recurrent hernias after TEP.
- Analysis of intraoperative findings in recurrent cases.
- Comparison of recurrence rates between TEP and open Lichtenstein hernioplasty.
Main Results:
- Six recurrences occurred after 1,093 TEP procedures (overall rate 0.27%).
- Four recurrences (67%) happened within months, suggesting technical issues.
- Half of recurrences were linked to sliding lipomas without peritoneal sacs.
- Untreated herniated retroperitoneal adipose tissue was identified as a primary cause.
Conclusions:
- Herniated retroperitoneal adipose tissue is a significant factor in TEP recurrence.
- Routine exploration and resection of retroperitoneal fat during TEP are recommended.
- Optimizing TEP technique can further decrease hernia recurrence rates.
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