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Laparoscopic treatment (reTAPP) for recurrence after laparoscopic inguinal hernia repair

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Abstract

Purpose

For inguinal hernia recurrences, the European Hernia Society guidelines recommend laparo-endoscopic repair (LR) following a previous open surgery (OS) and, conversely, OS following previous laparo-endoscopic repair. Laparoscopic treatment of recurrences after previous LR is controversial. The purpose of this study was to determine the safety, feasibility, and reliability of a repeated transabdominal preperitoneal laparoscopic repair (reTAPP) for a recurrent hernia.

Methods

We analyzed and compared a series of patients with recurrent inguinal hernia after LR who underwent repair by a conventional approach with similar patients who underwent reTAPP between January 2010 and December 2018.

Results

Between January 2010 and December 2018, 2488 transabdominal preperitoneal laparoscopic inguinal hernia (TAPP) repairs were performed. Recurrence was observed in 46 (1.8%). Of these patients, 18 (39%; Group 1; G1) underwent conventional open repair (Lichtenstein technique) and 28 (61%; Group 2; G2) reTAPP. In G2, repair was successful in 24 patients (86%); however, four cases (14%) needed conversion to OS because of technical difficulties. Two patients re-recurred (4.3%), one in G1 which was resolved in a third approach with a reTAPP and the other in G2 which was resolved with OS.

Conclusion

ReTAPP surgery for recurrences after previous TAPP repair proved to be safe and was associated with a shorter length of hospital stay and morbidity and recurrence rates comparable to OS at a highly specialized center. Randomized studies with a larger number of cases are necessary to confirm these findings and draw more robust and objective conclusions.

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References

  1. Simons MP, Smietanski M, Bonjer HJ et al (2018) International guidelines for groin hernia management. Hernia. https://doi.org/10.1007/s10029-017-1668-x

    Article  PubMed  Google Scholar 

  2. McCormack K, Scott N, Go PMNY, Ross SJ, Grant A (2003) Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.cd001785

    Article  PubMed  PubMed Central  Google Scholar 

  3. Liem MSL, Van Duyn EB, Van der Graaf Y, Van Vroonhoven TJMV (2003) Recurrences after conventional anterior and laparoscopic inguinal hernia repair: a randomized comparison. Ann Surg 237(1):136–141. https://doi.org/10.1097/00000658-200301000-00019

    Article  PubMed  PubMed Central  Google Scholar 

  4. Bisgaard T, Bay-Nielsen M, Kehlet H (2008) Re-recurrence after operation for recurrent inguinal hernia. A nationwide 8-year follow-up study on the role of type of repair. Ann Surg 247(4):707–711. https://doi.org/10.1097/sla.0b013e31816b18e3

    Article  PubMed  Google Scholar 

  5. Simons MP, Aufenacker T, Bay-Nielsen M et al (2009) European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia. https://doi.org/10.1007/s10029-009-0529-7

    Article  PubMed  PubMed Central  Google Scholar 

  6. Richards SK, Vipond MN, Earnshaw JJ (2004) Review of the management of recurrent inguinal hernia. Hernia 8(2):144–148. https://doi.org/10.1007/s10029-003-0194-1

    Article  CAS  PubMed  Google Scholar 

  7. Eklund A, Rudberg C, Leijonmarck CE et al (2007) Recurrent inguinal hernia: randomized multicenter trial comparing laparoscopic and Lichtenstein repair. Surg Endosc Other Interv Tech. 21(4):634–640. https://doi.org/10.1007/s00464-006-9163-y

    Article  CAS  Google Scholar 

  8. Ertem M, Ozben V, Gok H, Ozveri E (2013) Relaparoscopic treatment of recurrences after previous laparoscopic inguinal hernia repair. Minim Invasive Surg. https://doi.org/10.1155/2013/260131

    Article  PubMed  PubMed Central  Google Scholar 

  9. Köckerling F, Schug-Pass C (2017) Diagnostic laparoscopy as decision tool for re-recurrent inguinal hernia treatment following open anterior and laparo-endoscopic posterior repair. Front Surg. 4:1–8. https://doi.org/10.3389/fsurg.2017.00022

    Article  Google Scholar 

  10. Köckerling F, Bittner R, Kuthe A et al (2017) Laparo-endoscopic versus open recurrent inguinal hernia repair: should we follow the guidelines? Surg Endosc 31(8):3168–3185. https://doi.org/10.1007/s00464-016-5342-7

    Article  PubMed  Google Scholar 

  11. Van Den Heuvel B, Dwars BJ (2013) Repeated laparoscopic treatment of recurrent inguinal hernias after previous posterior repair. Surg Endosc 27(3):795–800. https://doi.org/10.1007/s00464-012-2514-y

    Article  PubMed  Google Scholar 

  12. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213. https://doi.org/10.1097/01.sla.0000133083.54934.ae

    Article  PubMed  PubMed Central  Google Scholar 

  13. Clavien PA, Barkun J, De Oliveira ML et al (2009) The Clavien–Dindo classification of surgical complications: five-year experience. Ann Surg 250(2):187–196. https://doi.org/10.1097/SLA.0b013e3181b13ca2

    Article  PubMed  Google Scholar 

  14. Köckerling F, Jacob D, Wiegank W et al (2016) Endoscopic repair of primary versus recurrent male unilateral inguinal hernias: Are there differences in the outcome? Surg Endosc 30(3):1146–1155. https://doi.org/10.1007/s00464-015-4318-3

    Article  PubMed  Google Scholar 

  15. Pisanu A, Podda M, Saba A, Porceddu G, Uccheddu A (2015) Meta-analysis and review of prospective randomized trials comparing laparoscopic and Lichtenstein techniques in recurrent inguinal hernia repair. Hernia 19(3):355–366. https://doi.org/10.1007/s10029-014-1281-1

    Article  CAS  PubMed  Google Scholar 

  16. Knook MTT, Weidema WF, Stassen LPS, Van Steensel CJ (1999) Laparoscopic repair of recurrent inguinal hernias after endoscopic herniorrhaphy. Surg Endosc 13(11):1145–1147. https://doi.org/10.1007/s004649901191

    Article  CAS  PubMed  Google Scholar 

  17. Sevonius D, Gunnarsson U, Nordin P, Nilsson E, Sandblom G (2011) Recurrent groin hernia surgery. Br J Surg 98(10):1489–1494. https://doi.org/10.1002/bjs.7559

    Article  CAS  PubMed  Google Scholar 

  18. Deans GT, Wilson MS, Royston CMS, Brough WA (1995) Recurrent inguinal hernia after laparoscopic repair: possible cause and prevention. Br J Surg 82(4):539–541. https://doi.org/10.1002/bjs.1800820433

    Article  CAS  PubMed  Google Scholar 

  19. Leibl BJ, Schmedt CG, Kraft K, Ulrich M, Bittner R (2000) Recurrence after endoscopic transperitoneal hernia repair (TAPP): causes, reparative techniques, and results of the reoperation. J Am Coll Surg 190(6):651–655. https://doi.org/10.1016/S1072-7515(00)00262-3

    Article  CAS  PubMed  Google Scholar 

  20. Felix E, Scott S, Crafton B et al (1998) Causes of recurrence after laparoscopic hernioplasty: a multicenter study. Surg Endosc 12(3):226–231. https://doi.org/10.1007/s004649900640

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. General Surgery Department, Hospital Británico de Buenos Aires, Perdriel 74, 1280, Buenos Aires, Argentina

    Joaquin Fernandez-Alberti, Facundo Iriarte, Raul Eduardo Croceri & Daniel Enrique Pirchi

  2. Abdominal Wall Surgery Department, Hospital Británico de Buenos Aires, Perdriel 74, 1280, Buenos Aires, Argentina

    Pablo Medina & Eduardo Agustin Porto

Authors
  1. Joaquin Fernandez-Alberti
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  2. Facundo Iriarte
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  3. Raul Eduardo Croceri
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  4. Pablo Medina
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  5. Eduardo Agustin Porto
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  6. Daniel Enrique Pirchi
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Drs. JF, FI, REC, PM, EAP, and DEP. The first draft of the manuscript was written by JF, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Joaquin Fernandez-Alberti.

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Conflict of interest

Drs. Joaquin Fernandez-Alberti, Facundo Iriarte, Raul Eduardo Croceri, Pablo Medina, Eduardo Agustin Porto, and Daniel Enrique Pirchi have no conflicts of interest or financial ties to disclose. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Human and animal rights

This article does not contain any study with animals performed by any of the authors.

Ethics approval

Ethical approval was waived by the local Ethics Committee of the British Hospital of Buenos Aires in view of the retrospective nature of the study, and all the procedures being performed were part of the routine care.

Consent to participate

Due to the retrospective nature of the study, the Ethics Committee waived the requirement for written informed consent; however, all patients signed the surgical consent form.

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Fernandez-Alberti, J., Iriarte, F., Croceri, R. et al. Laparoscopic treatment (reTAPP) for recurrence after laparoscopic inguinal hernia repair. Hernia 25, 1301–1307 (2021). https://doi.org/10.1007/s10029-020-02357-6

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  • DOI: https://doi.org/10.1007/s10029-020-02357-6

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