BACKGROUND: Recurrence after primary conventional inguinal herniorrhaphy occurs in approximately 10% of @entity1 depending on the type of repair and expertise of the surgeon. The repair of the resulting recurrent @entity547 is a daunting task because of already weakened tissues and obscured and distorted anatomy. The failure rate of these repairs using an open anterior approach may reach as high as 36%. Because of such a high failure rate, a number of investigators have focused on repairing these difficult recurrent @entity547 laparoscopically using a tension-free approach. Some of the earlier reports suggested a low recurrence rate of 0.5% to 5% when a laparoscopic approach was used to repair these @entity547 . The purpose of this study was to evaluate the efficacy of laparoscopic treatment for recurrent @entity547 in our institutions. METHODS: Between February 1991 and February 1995, 96 recurrent @entity547 were repaired in 85 @entity1 (78 @entity1 and 7 @entity1 ). There were 48 right, 26 left, and 11 @entity547 . The mean age of the @entity1 was 59 years (range, 18-86 years); the mean height was 69 in. (range, 54-77 in.); and the mean weight was 176 pounds (range, 109-280 pounds). A total of 68 herniorrhaphies were performed using the transabdominal preperitoneal (TAPP) method: 19 using intraperitoneal on-lay mesh (IPOM) repair and 8 using the total extraperitoneal (TEP) method. The method of repair in one @entity1 was not recorded. The mean operating time was 76 min (range, 47-172 min). Thirteen @entity1 underwent additional procedures. RESULTS: Long-term follow-up was performed by questionnaire, examination, or both in 76 @entity1 (85 @entity547 ). Median follow-up time was 27 months (range, 2-56 months). There were four recurrences (2 in IPOM and 2 in TAPP). Three of these were repaired laparoscopically and one conventionally. There were 20 minor and 14 major complications and no mortality. One conversion occurred in the TAPP group. Mean postoperative stay was 1.4 days (range, 0-4 days). It was felt by 92% of the @entity1 that their symptoms were completely relieved, whereas 4% of the @entity1 continued to exhibit symptoms for which their @entity547 was repaired, and 3.6% failed to answer. As reported, 86% of the @entity1 preferred their laparoscopic repair; 1% preferred the conventional repair; and 13% failed to reply. Afterward, 77% of the @entity1 returned to normal activity, and 35% returned to vigorous activity within 4 weeks of surgery. Satisfaction with laparoscopic repair was expressed by 92% of the @entity1 , whereas 8% either were dissatisfied or did not answer. In the end, 95% of the @entity1 stated that they would recommend laparoscopic @entity547 surgery to their family and friends. CONCLUSIONS: These preliminary data show that laparoscopic repair of recurrent @entity169 is a safe alternative procedure with acceptable rates of recurrence and complications.

Laparoscopic repair of recurrent XXXX .

@entity1 :: ('9606', 'Species') :: ['women', 'patients', 'patient', 'men'] @entity169 :: ('MESH:D006552', 'Disease') :: ['inguinal hernia'] @entity547 :: ('MESH:D006547', 'Disease') :: ['hernia', 'hernias', 'bilateral hernias']
@entity547 :: (MESH:D006547,Disease) :: ['hernias']
