JKSS Journal of the Korean Surgical Society pISSN 2233-7903ㆍeISSN 2093-0488 J Korean Surg Soc 2011;80:313-318 DOI: 10.4174/jkss.2011.80.5.313 ORIGINAL ARTICLE Clinical usefulness of laparoscopic total extraperitoneal hernia repair for recurrent inguinal hernia In Sik Jang, Sang Mok Lee, Joo Hyun Kim, Beum Su Kim, Sung Il Choi Department of Surgery, Kyung Hee University School of Medicine, Seoul, Korea Purpose: Hernia repair after recurrence is a challenging procedure, and many approaches have been suggested for it. Total extraperitoneal (TEP) hernia repair should be considered in recurrent hernia. This study was conducted for the purpose of in- vestigating the clinical usefulness of laparoscopic TEP hernia repair for recurrent inguinal hernia. Methods: Among the 191 patients who underwent TEP hernia repair at these authors’ center from June 2006 to January 2010, the bilateral-hernia cases and the patients with a history of previous pelvic surgery were excluded. A total of 19 patients (12.5%) were enrolled in the recurrent-inguinal-hernia group (group R), and 133 patients (87.5%) in the primary-hernia group (group P). Data were inves- tigated retrospectively, based on the medical records. Results: The mean operation time was 97 minutes in group R and 99 mi- nutes in group P (＞0.05). In group R, no operation modality change occurred, and temporary urinary retention was devel- oped in four patients (21.1%). In group P, on the other hand, operation modality change from TEP to the transabdominal pre- peritoneal approach was necessary in four patients (3%). Additionally, in group P, 30 patients (22.6%) had temporary urinary retention and six (4.5%) had testicular edema. No recurrence was identified during the follow-up period in both groups (mean follow-up period: 15.8 months for group R and 18.0 months for group P). Conclusion: Laparoscopic TEP hernia repair seems to be a safe and useful method for correcting recurrent inguinal hernia. Key Words: Recurrent inguinal hernia, Laparoscopy, Total extraperitoneal approach INTRODUCTION Inguinal hernia surgery is one of the most commonly conducted surgeries in the world; it is conducted 700,000 cases a year in the United States [1] and is also a very com- mon surgery in South Korea. Since its introduction by Bassini [2] in 1887, various inguinal hernia surgery meth- ods have been introduced by many surgeons. The re- currence rate after inguinal hernia surgery has been re- ported to be less than 5% in the case of atonic surgery, Received October 31, 2010, Accepted February 22, 2011 which was developed by Lichtenstei. As it is technically difficult, however, to conduct reoperation due to adhesion and the deformity of the anatomical structure caused by a previous surgery, the recurrence and complication rates have been reported to be higher by up to 25% [3,4]. Laparoscopic hernia repair has been recognized as an ex- cellent surgery of late and is widely conducted on patients with recurrent inguinal hernia [5]. In this study, laparo- scopic total extraperitoneal (TEP) hernia repair was con- ducted on patients with recurrent inguinal hernia to inves- Correspondence to: Sang Mok Lee Department of Surgery, Kyung Hee University School of Medicine, 1 Hoegi-dong, Dongdaemun-gu, Seoul 130-701, Korea Tel: +82-2-958-8269, Fax: +82-2-966-9366, E-mail: hbplapa@khu.ac.kr cc Journal of the Korean Surgical Society is an Open Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright © 2011, the Korean Surgical Society