Repair of Recurrent Inguinal Hernia After Endoscopic Tep Hernioplasty Through Tapp Approach

Abstract Objective To demonstrate the feasibility of repairing recurrent inguinal hernias following endoscopic TEP hernioplasty using a laparoscopic TAPP approach. Materials and Methods A 71-year-old male patient with no significant personal history underwent bilateral TEP hernioplasty in 2021. He presented with a right inguinal hernia on consultation. Abdominopelvic CT was requested, confirming a recurrent indirect right inguinal hernia. A TAPP approach was chosen, revealing a recurrent indirect inguinal hernia due to medial displacement of the mesh, classified as L3r according to the EHS classification. Repair was performed through the TAPP approach without removal of the previous mesh, with traumatic fixation of the new mesh to the pubis. Results Postoperative period was uneventful, with discharge 24 hours after surgery. The first follow-up at 10 days post-intervention showed that the patient only required continuous analgesia in the first 24 hours. Three months after surgery, the patient reported no pain, physical examination showed no recurrence (complications), and excellent aesthetic results. Conclusions Minimally invasive repair of inguinal hernias is not only advisable for primary hernias but should also be the treatment of choice for recurrent hernias through laparo-endoscopic approaches. Although repair may be more challenging due to fibrosis from previous surgery, in expert hands, it can be performed with the utmost safety for the patient.