[THE PROBLEM OF CHOOSING A METHOD FOR RECURRENT INGUINAL HERNIA REPAIR]

Area of Science:

• General Surgery
• Minimally Invasive Surgery

Background:

• Inguinal hernia repair is a common general surgery procedure worldwide.
• Recurrence rates after initial inguinal hernia repair range up to 15%, necessitating effective re-intervention strategies.
• Laparoscopic techniques offer benefits like reduced pain and shorter hospital stays compared to open surgery.

Purpose of the Study:

• To determine the optimal surgical method for recurrent inguinal hernias.
• To compare laparoscopic techniques (TAPP) with modified Lichtenstein repair for recurrent inguinal hernias.

Main Methods:

• A randomized comparative study of 82 patients with recurrent inguinal hernias from 2007-2011.
• Group I: Laparoscopic transabdominal preperitoneal (TAPP) repair.
• Group II: Modified Lichtenstein open repair.

Main Results:

• Laparoscopic repair (Group I) had a shorter operative time (87±12 min) and fewer complications than open repair (Group II, 112±15 min).
• Group II experienced higher rates of severe pain (69%), seroma (35.7%), and recurrence (9.5%).
• Laparoscopic re-operations showed advantages in reduced complications and recurrences, though 16.7% required conversion to open repair due to technical difficulty.

Conclusions:

• Laparoscopic methods are advantageous for recurrent inguinal hernia re-operations, offering reduced complications and pain.
• Successful laparoscopic re-hernioplasty can achieve good short- and long-term outcomes.
• Careful patient selection is crucial for optimizing outcomes in laparoscopic re-interventions for recurrent inguinal hernias.