LAPAROSCOPIC REPAIR OF RECURRENT GROIN HERNIAS

Between November 1991 and May 1993, 54 recurrent groin hernias were laparoscopically repaired in 50 patients. Forty-eight were men and two were women. Forty-six recurrent hernias were unilateral and four bilateral. Twenty-five were direct, 19 indirect, 10 pantaloon, and two had a femoral component. In only 10 patients was the contralateral side normal. In 27 patients, the other side had been previously repaired, and in 13 they had a new contralateral hernia. A transabdominal preperitoneal technique was used to dissect and repair the entire floor in all patients. A single sheet of polypropylene mesh was used in the repair of the women patients, and a double-buttress technique with the first sheet slitted for the cord was used for the men. Patients were examined every 3 months for the first year and at 6-month intervals thereafter. Follow-up ranged from 1 to 18 months with a mean of 8 months. No patient was lost to follow-up, and no recurrence was observed. Patients returned to normal activity in an average of 1 week. Seroma, which resolved spontaneously, was the most common complication. The overall short-term results suggested that a laparoscopic mesh buttressed repair of recurrent groin hernias is technically feasible and can eliminate early rerecurrence of the hernia so commonly seen after repair of recurrent hernias.