Skip to main content
SpringerLink
Log in

Recurrence following endoscopic extraperitoneal inguinal hernioplasty

  • Original Article
  • Published:
Hernia Aims and scope Submit manuscript

Abstract

Recurrence rate is the utmost outcome parameter in determining the clinical effectiveness of any hernia surgery. Between June 1999 and September 2004, six patients presented with recurrent hernia after endoscopic totally extraperitoneal inguinal hernioplasty (TEP). Four of the six recurrences (67%) occurred within a few months after TEP, indicating a technical failure. Of the 1,093 TEPs performed by the author, a total of three patients developed recurrence, giving an overall recurrence rate of 0.27%. All six patients underwent open Lichtenstein hernioplasty. Intraoperative findings showed recurrent indirect inguinal hernia in all patients. Half of the recurrence (n=3) was due to a sliding lipoma without a peritoneal hernial sac. Untreated herniated retroperitoneal adipose tissue into the internal inguinal ring during initial TEP constitutes the leading cause of recurrence after TEP. Routine exploration of internal ring for any herniated retroperitoneal adipose tissue during TEP is recommended. Herniated retroperitoneal adipose tissue should be resected whenever feasible.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kumar S, Nixon SJ, MacIntyre IM (1999) Laparoscopic or Lichtenstein repair for recurrent inguinal hernia: one unit’s experience. J R Coll Surg Edinb 5:301–302

    CAS  Google Scholar 

  2. Liem MS, van der Graaf Y, van Steensel CJ et al (1997) Comparison of conventional anterior surgery and laparoscopic surgery for inguinal hernia repair. N Engl J Med 336:1541–1547

    Article  PubMed  CAS  Google Scholar 

  3. Ferzli GS, Shapiro K, DeTurris SV et al (2004) Totally extraperitoneal (TEP) hernia repair after an original TEP. Is it safe, and is it even possible? Surg Endosc 18:526–528

    CAS  Google Scholar 

  4. Knook MT, Weidema WF, Stassen LP et al (1999) Laparoscopic repair of recurrent inguinal hernias after endoscopic herniorrhaphy. Surg Endosc 13:1145–1147

    Article  PubMed  CAS  Google Scholar 

  5. Rutkow IM (1995) The recurrence rate in hernia surgery. How important is it? Arch Surg 130:575–576

    CAS  Google Scholar 

  6. Lau H, Patil NG, Yuen WK (2006) Day-case endoscopic totally extraperitoneal inguinal hernioplasty versus open Lichtenstein hernioplasty for unilateral primary inguinal hernia in males: a randomized trial. Surg Endosc 20:76–81

    Article  PubMed  CAS  Google Scholar 

  7. Tamme C, Scheidbach H, Hampe C et al (2003) Totally extraperitoneal endoscopic inguinal hernia repair (TEP). Surg Endosc 17:190–195

    Article  PubMed  CAS  Google Scholar 

  8. Liem MS, van Duyn EB, van der Graaf Y et al (2003) Recurrences after conventional anterior and laparoscopic inguinal hernia repair: a randomized comparison. Ann Surg 237:136–141

    Article  PubMed  Google Scholar 

  9. Wright D, Paterson C, Scott N et al (2002) Five-year follow-up of patients undergoing laparoscopic or open groin hernia repair: a randomized controlled trial. Ann Surg 235:333–337

    Article  PubMed  Google Scholar 

  10. Ramshaw B, Schuler FW, Jones HB et al (2001) Laparoscopic inguinal hernia repair. Lessons learned after 1224 consecutive cases. Surg Endosc 15:50–54

    CAS  Google Scholar 

  11. Aeberhard P, Klaiber C, Meyenberg A et al (1999) Prospective audit of laparoscopic totally extraperitoneal inguinal hernia repair: a multicenter study of the Swiss Association for Laparoscopic and Thoracoscopic Surgery (SALTC). Surg Endosc 13:1115–1120

    Article  PubMed  CAS  Google Scholar 

  12. Phillips EH, Rosenthal R, Fallas M et al (1995) Reasons for early recurrence following laparoscopic hernioplasty. Surg Endosc 9:140–145

    PubMed  CAS  Google Scholar 

  13. Felix E, Scott S, Craftton B et al (1998) Causes of recurrence after laparoscopic hernioplasty. A multicenter study. Surg Endsoc 12:226–231

    CAS  Google Scholar 

  14. Leibl BJ, Schmedt CG, Kraft K et al (2000) Recurrence after endoscopic transperitoneal hernia repair (TAPP): causes, reparative techniques, and results of the reoperation. J Am Coll Surg 190:651–655

    Article  PubMed  CAS  Google Scholar 

  15. Lowham AS, Filipi CJ, Fitzgibbons RJ Jr et al (1997) Mechanisms of hernia recurrence after preperitoneal mesh repair. Traditional and laparoscopic. Ann Surg 225:422–431

    CAS  Google Scholar 

  16. Lau H, Patil NG, Yuen WK et al (2002) Learning curve for unilateral endoscopic totally extraperitoneal inguinal hernioplasty. Surg Endosc 16:1724–1728

    Article  PubMed  CAS  Google Scholar 

  17. Deans GT, Wilson MS, Royston CM et al (1995) Recurrent inguinal hernia after laparoscopic repair: possible cause and prevention. Br J Surg 82:539–541

    Article  PubMed  CAS  Google Scholar 

  18. Lau H (2004) Sliding lipoma: an indirect inguinal hernia without a peritoneal sac. J Laparoendosc Adv Surg Tech A 14:57–59

    Article  PubMed  Google Scholar 

  19. Gersin KS, Heniford BT, Garcia-Ruiz A et al (1999) Missed lipoma of the spermatic cord. A pitfall of transabdominal preperitoneal laparoscopic hernia repair. Surg Endosc 13:585–587

    CAS  Google Scholar 

  20. Lilly MC, Arregui ME (2002) Lipomas of the cord and round ligament. Ann Surg 235:586–590

    Article  PubMed  Google Scholar 

  21. Lau H (2004) Endoscopic totally extraperitoneal inguinal hernioplasty for recurrence after open repair. ANZ J Surg 74:877–880

    Article  PubMed  Google Scholar 

  22. Dion YM, Laplante R, Charara J et al (1994) The influence of the number of endoclips and of mesh incorporation on the strength of an experimental hernia patch repair. Surg Endosc 8:1324–1328

    PubMed  CAS  Google Scholar 

  23. Hollinsky C, Gobl S (1999) Bursting strength evaluation after different types of mesh fixation in laparoscopic herniorrhaphy. Surg Endosc 13:958–961

    Article  PubMed  CAS  Google Scholar 

  24. Choy C, Shapiro K, Patel S et al (2004) Investigating a possible cause of mesh migration during totally extraperitoneal (TEP) repair. Surg Endosc 18:523–525

    Article  PubMed  CAS  Google Scholar 

  25. Klinge U, Klosterhalfen B, Muller M et al (1998) Shrinking of polypropylene mesh in vivo: an experimental study in dogs. Eur J Surg 164:965–969

    Article  PubMed  CAS  Google Scholar 

  26. Coda A, Bendavid R, Botto-Micca F et al (2003) Structural alterations of prosthetic meshes in humans. Hernia 7:29–34

    PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The author wishes to acknowledge the kind assistance of Tze-Ching Tan, FRCS, in editing the manuscript.

Author information

Authors and Affiliations

  1. Department of Surgery, University of Hong Kong Medical Center, Queen Mary Hospital, Pokfulam, Hong Kong SAR, China

    H. Lau

  2. Quality Health Medical Centre, 501-7, Prince’s Building, 10 Chater Road, Central, Hong Kong SAR, China

    H. Lau

Authors
  1. H. Lau
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to H. Lau.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lau, H. Recurrence following endoscopic extraperitoneal inguinal hernioplasty. Hernia 11, 415–418 (2007). https://doi.org/10.1007/s10029-007-0246-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10029-007-0246-z

Keywords

Search

Navigation