Laparoscopic Approach to Complex Inguinal Hernia: A Feasible Option

Abstract Aim The aim of our study is to demonstrate the safety of laparoscopic approach of complex inguinal hernia, defined as multirecurrent or with previous pelvic surgery according to the European Hernia Society (EHS). Material and Methods A retrospective cohort study was conducted, including all patients undergoing laparoscopic inguinal hernioplasty in our Abdominal Wall Surgery Unit from 2020 to 2022. Comparative analysis between two groups: the study group with complex inguinal hernia (multirecurrent and/or with previous pelvic surgery) and the control group was performed. Results 132 cases were included in the study, with 28 (21.2%) having complex inguinal hernia. The mean follow-up was 12.7 +/- 7.44 months. 120 cases (90.9%) had comorbidities. Study groups were comparable, except for a higher number of smokers in the study group (14 (13.5%) vs. 9 (32.1%); p = 0.025). Hernia characteristics showed a higher percentage of bilateral hernias in the control group (68 (65%) vs. 12 (42.9%); p = 0.027) and a higher percentage of recurrent hernias in complex cases (33 (31.7%) vs. 16 (57.1%); p = 0.013). No differences were found in complications, both groups were comparable (8 (7.7%) vs. 2 (7.1%); p = 0.642). One case of recurrence was observed in the control group, one case of conversion and reintervention due to occlusion in the study group, and one readmission in each group. Finally, in long-term follow-up, there was one case of chronic pain in the study group and only one recurrence in the control group. Conclusions The laparoscopic approach to complex inguinal hernia appears feasible, with results like non-complex cases.