The Advantages of the Laparoscopic Approach in Multi-Recurrent Inguinal Hernia

Abstract Background Recurrence after inguinal hernia repair remains a clinical problem in current surgery, with a rate of the 13% of all groin hernia repairs. This surgery is technically more demanding for the surgeon. The technique to be used must follow the objective of repair the hernia via virgin tissue planes. We describe the advantages of the laparoscopic TAPP aproach in these cases. Method We present the clinical case of a 64-year-old woman with a multi-recurrent right inguinal hernia. The previous surgeries were: Lichtenstein's open repair and open posterior preperitoneal mesh repair twice. We performed a preperitoneal right inguinal hernioplasty with a transperitoneal laparoscopic approach. A hernia recurrence was found in the right medial zone, juxtapubic with visceral content, R3M3 in the EHS classification for inguinal hernia. A plication of the transversalis fascia was performed, and later a 3D polypropylene mesh fixed with resorbable tacks was placed. Results The patient was discharged after 24 hours. She was evaluated in an outpatient clinic one month postoperatively. She did not present hernia recurrence or other incidents. Conclusions As we can see, minimally invasive repair of recurrent inguinal hernia is safe and feasible. One of the most important advantages of using the laparoscopic approach in cases with recurrent inguinal hernia is that it avoids the previous operation site, avoiding injuries and difficulties in repair due to previous tissue fibrosis. Safety of the procedure is dependent on skilled and well-trained hands for this procedure.