Analysis of mesh-related factors associated with recurrence and treatment outcomes after laparoscopic inguinal hernia repair.

Abstract

<h4>Purpose</h4>To analyze the factors associated with recurrence and treatment outcomes after laparoscopic inguinal hernia repair. Furthermore, to discuss how outcomes could be improved.<h4>Methods</h4>This was a retrospective study of data of 41 patients who had undergone laparoscopic surgeries for recurrent inguinal hernias after laparoscopic inguinal hernia repair in the Hernia and Abdominal Wall Surgery Department of Beijing Chaoyang Hospital, Capital Medical University from January 2017 to December 2021. We collected and analyzed baseline characteristics, factors associated with recurrence, and outcomes of surgical treatment.<h4>Results</h4>Of the 41 study patients, 31 (75.61%) had recurrences after transabdominal preperitoneal (TAPP) surgery, and 10 had recurrences after totally extraperitoneal surgery. The recurrent hernia was managed by TAPP in 11 of these patients and by the Lichtenstein procedure in the remaining 30 patients 30. Factors associated with recurrence were separated into four categories; namely, insufficient patch coverage in 23 cases (56.10%), folding of the patch in nine (21.95%), patch contraction in seven (17.07%), and incorrect patch fixation in two (4.88%). During follow-up after surgical treatment of the recurrence, there were no further recurrences, infection, chronic pain, or foreign body sensation occurred in any patient. There was no significant difference in the incidence of postoperative seroma between TAPP and the Lichtenstein procedure.<h4>Conclusions</h4>Most recurrences after laparoscopic inguinal hernia repair are caused by insufficient patch coverage. Standardized surgical procedures should be performed. Both TAPP and the Lichtenstein procedure are effective treatments for recurrence.