Abstract
Aim
To report feasibility and surgical outcomes of recurrent inguinal hernia repair after TransInguinal PrePeritoneal (TIPP) repair.
Material and Methods
Patients who underwent recurrent IHR after TIPP between January 2013 and January 2015 in a single hernia-dedicated teaching hospital were included. Exclusion criteria were femoral hernia, incarcerated hernia and reasons for unreliable follow-up. Electronic medical records were assessed retrospectively to register surgical outcomes and complications.
Results
Thirty-three patients underwent surgical repair of recurrent inguinal hernia after TIPP. Twenty patients were treated with a “re-TIPP when possible” strategy; resulting in 13 successful re-tipps and 7 conversions to Lichtenstein repair. Eleven patients underwent primarily a Lichtenstein’s repair, the remaining two patients underwent recurrent IHR using other techniques (transrectus sheath Pre-Peritoneal and transabdominal preperitoneal repair). Mean time of surgery was 44.7 minutes (standard deviation 16.7). There was one patient (3.0%) with a re-recurrent inguinal hernia during follow-up. Other minor complications included urinary tract infection. There were no significant differences in post-operative results between the different surgical techniques used for recurrent IHR.
Conclusions
These results indicate that after TIPP it is feasible and safe to perform re-surgery for recurrence with an anterior approach again. For these recurrences, a Lichtenstein can be performed, or a ‘re-TIPP if possible’ strategy can be applied by experienced TIPP surgeons. Whether a re-TIPP has the same advantages over Lichtenstein as is for primary inguinal hernia surgery, needs to be evaluated in a prospective manner.
Long-term follow-up evaluation of chronic pain after endoscopic total extraperitoneal repair of primary and recurrent inguinal hernia