Arregui and Nagan [16], 5% in a study by Fitzgibbons et al. [17], 10.67% in a study by Fiennes and Taylor [18], and 16.8% in a study by MacFadyen and Mathis [19]. In the study conducted by MacFadyen and Mathis, the compli- cation rate after posterior peritoneal repair included re- currence (3.2%), testicular edema (1.6%), bladder injury (1%), abdominal distension (0.5%), urinary retention (0.5%), and pelvic osteitis (0.5%); the complication rate af- ter the transabdominal preperitoneal approach included recurrence (0.8%), hematoma (3%), thigh pain (2.2%), scro- tal emphysema (2.2%), and urinary retention (1.1%); and the complication rate after the anterior extraperitoneal ap- proach included hematoma (6.6%) and testicular pain (1.1%). Most of the complications were improved with conservative treatments within three weeks. Chronic pain [20,21] has been reported to occur in approximately 9.2-14% after TEP surgery. Chronic pain after TEP surgery is likely to be attributable to nociceptive, neurogenic, and combined pain associated with tissue injury. It is difficult, however, to exactly identify whether the precise cause of the pain is attributable to a neuronal injury occurring dur- ing the surgery or to a chronic response to foreign materi- als due to mesh. In this study, the complication rate was shown to be 21.1%. No major complications, such as vascular injury, in- fection, visceral organ injury, hematoma, recurrence, and chronic pain, were found, and four cases of temporary uri- nary retention were observed. In conclusion, despite the shorter follow-up period and the smaller subject size, considering its hernia correction which cannot be found in the previous surgeries, advant- age of less invasive surgery, and lower complication and recurrence rates, laparoscopic TEP hernia repair can be considered a safe and useful treatment of recurrent in- guinal hernia. CONFLICTS OF INTEREST No potential conflict of interest relevant to this article was reported. thesurgery.or.kr Laparoscopic TEP hernia repair for recurrent inguinal hernia REFERENCES 1. Nathan JD, Pappas TN. Inguinal hernia: an old condition with new solutions. Ann Surg 2003;238(6 Suppl):S148-57. 2. Bassini E. Nuovo metodo per la cura radicale dell'ernia inguinale. Atti Congr Assoc Med Ital 1887;2:179. 3. Lichtenstein IL, Shulman AG, Amid PK, Montllor MM. The tension-free hernioplasty. Am J Surg 1989;157:188-93. 4. Lichtenstein IL, Shulman AG, Amid PK. The cause, pre- vention, and treatment of recurrent groin hernia. Surg Clin North Am 1993;73:529-44. 5. Feliu X, Torres G, Viñas X, Martínez-Ródenas F, Fernán- dez-Sallent E, Pie J. Preperitoneal repair for recurrent in- guinal hernia: laparoscopic and open approach. Hernia 2004;8:113-6. 6. Ramshaw B, Abiad F, Voeller G, Wilson R, Mason E. Polyester (Parietex) mesh for total extraperitoneal laparo- scopic inguinal hernia repair: initial experience in the United States. Surg Endosc 2003;17:498-501. 7. Ferzli GS, Massaad A, Dysarz FA 3rd, Kopatsis A. A study of 101 patients treated with extraperitoneal endoscopic laparoscopic herniorrhaphy. Am Surg 1993;59:707-8. 8. Janu PG, Sellers KD, Mangiante EC. Recurrent inguinal hernia: preferred operative approach. Am Surg 1998;64: 569-73. 9. Klinge U, Zheng H, Si Z, Schumpelick V, Bhardwaj RS, Muys L, et al. Expression of the extracellular matrix pro- teins collagen I, collagen III and fibronectin and matrix metalloproteinase-1 and -13 in the skin of patients with in- guinal hernia. Eur Surg Res 1999;31:480-90. 10. Taylor CJ, Wilson T. Long-term results of laparoscopic to- tally extraperitoneal inguinal herniorrhaphy. ANZ J Surg 2005;75:637-9. 11. Czechowski A, Schafmayer A. TAPP versus TEP: a retro- spective analysis 5 years after laparoscopic transperitoneal and total endoscopic extraperitoneal repair in inguinal and femoral hernia. Chirurg 2003;74:1143-9. 12. Scheuerlein H, Schiller A, Schneider C, Scheidbach H, Tamme C, Köckerling F. Totally extraperitoneal repair of recurrent inguinal hernia. Surg Endosc 2003;17:1072-6. 13. Ferzli GS, Shapiro K, DeTurris SV, Sayad P, Patel S, Graham A, et al. Totally extraperitoneal (TEP) hernia repair after an original TEPIs it safe, and is it even possible? Surg Endosc 2004;18:526-8. 14. Read RC. Recurrence after preperitoneal herniorrhaphy in the adult. Arch Surg 1975;110:666-71. 15. Amid PK, Lichtenstein IL. Current assessment of Lichtenstein tension-free hernia repair. Chirurg 1997;68: 959-64. 16. Arregui ME, Nagan R. Inguinal hernia: advances or controversies. Oxford: Radcliffe Medical Press; 1994. 17. Fitzgibbons RJ Jr, Camps J, Cornet DA, Nguyen NX, Litke BS, Annibali R, et al. Laparoscopic inguinal herniorrhaphy. Results of a multicenter trial. Ann Surg 1995;221:3-13. 18. Fiennes AG, Taylor RS. Learning laparoscopic hernia re- pair: pitfalls and complications among 178 repairs. Oxford: Radcliffe Medical Press; 1994. 317