[Recurrence after hernia surgery: complication or natural course?]

Recurrence after hernia surgery remains a relevant measure of surgical quality. In order to correctly assess the recurrence rate the surgeon needs to distinguish clinical relevant recurrence, clinically irrelevant recurrence and pseudo-recurrence. Current surgical techniques for inguinal hernia repair using mesh are associated with a low rate of recurrence. Thus, recurrence after inguinal hernia surgery is seen as a surgical complication. Conversely, the recurrence rate for large incisional hernias remains above 10 % and in rare cases a recurrence might represent the natural course. Recurrent hernia can depend on the indication, choice of operation and surgical technique. Therefore, postoperative hernia recurrence probably does not represent the natural course but rather a surgical complication that needs to be prevented by an optimized surgical technique.