Abstract
The incidence and reasons for early recurrences following laparoscopic hernioplasty have not been studied. Because the incidence is small and the follow up is short, a multi-institutional study was performed among the pioneers in the field. The incidence figures were obtained by survey of surgeons who had significant experience (over 100 cases) and kept concurrent records.
Fifty-four recurrences (1.7%) occurred after 3229 laparoscopic hernia repairs. There were 1944 transabdominal preperitoneal (TAPP) repairs with 19 recurrences (1%) and 578 preperitoneal repairs with no recurrences. There were 345 onlay mesh (IPOM) repairs with seven recurrences (2%), and 286 plug and patch repairs with 26 recurrences (9%). Simple closures were performed 76 times with two recurrences (2.6%).
Fifty-seven patients (three cases were referred to the author without incidence data but complete records for analysis) had 60 recurrent hernias. Recurrences were noted, on average, 5.1 months postoperatively (range 0–30 months). The most common reason for recurrence was that the mesh was too small — 36 (60%). The mesh was never stapled in 19 instances (32%), and the hernia was never repaired in three cases (20%). The clips pulled through the tissue in six cases (8%), and in 10 cases (15%) the repair has not yet been undertaken because the etiology was unclear. There was more than one reason in 19 patients. Technical factors were responsible for nearly all recurrences.
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References
Arregui M, Navarrete JL (1992) Laparoscopic preperitoneal repair of inguinal hernias with mesh. In: Rosin D (ed) Minimal access general surgery. Radcliffe Medical Press Ltd, Oxford
Amid P, Shulman AG, Lichtenstein IL (1994) Die Herniotomie nach Lichtenstein. Chirurg 65 (in press)
Bassini E (1887) Un nuovo metodo per la cura radicale dell'ernia inguinale. Arch Soc It Chir, Genova Vol IV
Bassini E (1889) Un nuovo metodo per la cura radicale dell'ernia inguinale. Padua
Ben David R (1989) New techniques in hernia repair. World J Surg 13: 522–531
Butters AG (1948) A review of femoral hernias with special reference to recurrence rate of low operation Br Med J 2: 743
Chevrel JP (1985) Chirurgie des parois de l'abdomen. Springer Verlag, Berlin
Corbitt JD Jr (1991) Laparoscopic Herniorraphy. Surg Laparosc Endosc 1: 23–25
Fitzgibbons RJ (1991) Laparoscopic inguinal hernia repair. In: Proceedings of symposium on new frontiers in endosurgery, New Brunswick, NJ, Ethicon Inc.
Franklin M (1993) Laboratory rationale for intraperitoneal placement of mesh in inguinal hernia repair. Abstract in Hernia 93: Advances or controversies, Indianapolis, Indiana
Ger R (1982) The management of certain abdominal hernia by intraabdominal closure of the neck of the sac.—A preliminary communication. Ann R Coll Surg Eng 64: 342–343
Kux M, Fuchsjäger N, Feichter A (1994) Lichtenstein Patch versus Schouldice Technik bei primären Leistenhernien mit hohe Rezidivgefährdung. Der Chirurg 65: 1–4
Lichtenstein I, Shulman A, Amid P (1993) The cause, prevention and treatment of recurrent groin hernia. Surg Clin North Am 73: 3, 529–544
McKernan JB, Laws H (1992) Laparoscopic preperitoneal prosthetic repair of Inguinal Hernias. Surg Rounds 15: 597–608
Nyhus LM (1989) The preperitoneal approach and iliopublic tract repair of inguinal hernia. Chapter 8, pp 154–188. In: Nyhus LM, Condon RE (eds) Hernia, 3rd edition. Lippincott Company, Philadelphia
Obney N, Chan CK (1984) Repair of multiple recurrent inguinal hernias with reference to common causes of recurrence. Contemp Surg 25: 25
Phillips EH, Carroll BJ (1993) Laparoscopic inguinal hernia repair. Gastrointest Endosc Clin North Am 3: 297–307
Phillips EH, Carroll BJ, Fallas MJ (1993) Laparoscopic preperitoneal inguinal hernia repair without preperitoneal incision. Technique and early clinical results. Surg Endosc 7: 159–162
Read RC (1979) Bilaterality and the prosthetic repair of large recurrent inguinal hernias. Am J Surg 138: 788–793
Rutten P et al. (1992) Hernie inguinale primarie: herniplastie ambulatoire selon Lichtenstein: premiers resultats cliniques et implications economiques. Etude des 130 premiers cas Operes. Acta Chir Belg 92: 168–171
Schultz L, Graber J, Pietrafitta J, Hickok D (1990) Laser laparoscopic herniorraphy: A clinical trial—Preliminary results. J Laparoendosc Surg 1:1: 41–45
Seid A: The laparoscopic repair of recurrent inguinal hernias. In: Arregui M (eds) Inguinal hernia: advances or controversies. Radcliff Medical Press, Oxford, in press
Sewell RW, Wadell RL, Pollard RS, Purgett TG (1993) Evolution of the laparoscopic hernia repair. Abstract in Hernia 93: Advances or Controversies (in press)
Stoppa RE, Warlaumont CR (1989) The preperitoneal approach and prosthetic repair of groin hernia. In: Nyhus LM, Condon RE (eds) Hernia. JB Lippincott, Philadelphia, PA, pp 199–225
Toy FK, Smoot RT (1991) Toy-Smoot laparoscopic hernioplasty. Surg Laparosc Endosc 1: 151–155
Usher FC (1970) The repair of incisional and inguinal hernias. Surg Gynecol Obstet 131: 525
Welsh DRJ (1974) Inguinal hernia repair: a contemporary approach to a common procedure. Modern Medicine, vol. 2: 49–54
Wojciechowski A (1937) The Bassini operation. Some technical remarks. In: Fasíaní GM, Catterína A, (eds) Scritti Di Chirurgia Erniaria. Tipografia del Semínarío di Padova
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Phillips, E.H., Rosenthal, R., Fallas, M. et al. Reasons for early recurrence following laparoscopic hernioplasty. Surg Endosc 9, 140–145 (1995). https://doi.org/10.1007/BF00191954
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DOI: https://doi.org/10.1007/BF00191954