Long-Term Outcomes of Laparoscopic Total Extraperitoneal Repair for Recurrent Inguinal Hernia

Recurrent inguinal hernia remains a technically demanding clinical problem, particularly following previous anterior mesh repairs. The laparoscopic total extraperitoneal (TEP) approach offers a posterior access route that avoids previously disrupted tissue planes, yet real-world long-term outcome data in this specific population remain limited.

This retrospective study analyzed 65 patients (74 hernias) who underwent TEP repair for recurrent inguinal hernias between 2012 and 2023. All procedures were performed laparoscopically by a single experienced surgeon at a tertiary referral center using standardized techniques with anatomically preshaped meshes. Patient data were collected from hospital records, and outcomes were evaluated through follow-up periods of up to 141 months. The primary endpoint was rerecurrence rate; secondary endpoints included operative time, length of hospital stay, intraoperative complications, and short-term postoperative complications.

The mean operative time was 95.72 minutes, with a mean hospitalization duration of 2.4 days. During a mean follow-up of 57.7 months (range: 8-141 months), no recurrence was reported by patients or documented in the available clinical records. Short-term complications occurred in 8 patients (12.3%), including postoperative pain (n = 4, 6.15%), regional swelling (n = 2, 3.1%), seroma (n = 1, 1.5%), and hematoma (n = 1, 1.5%); all were Clavien-Dindo Grade I-II. No clinically significant chronic postoperative pain was recorded.

The TEP technique demonstrated favorable long-term outcomes in the management of recurrent inguinal hernias, with low complication and recurrence rates. However, its application requires significant surgical expertise, underscoring the importance of surgeon training and experience in achieving optimal results. These findings support TEP as a reliable and effective option for complex recurrent hernia cases in specialized centers.