Laparo-endoscopic versus open recurrent inguinal hernia repair: should we follow the guidelines?

Köckerling, F.; Bittner, R.; Kuthe, A.; Stechemesser, Bernd; Lorenz, R.; Koch, Andreas; Reinpold, Wolfgang; Niebuhr, H.; Hukauf, Martin; Schug-Paß, C.

doi:10.1007/s00464-016-5342-7

Cited by 38 publications

(29 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a registry study, 90.5% of patients out of 2,482 laparo-endoscopic recurrent repair operations and only 38.5% of patients out of the 2,330 open recurrent repair procedures were operated on in accordance with the guidelines [52]. The authors concluded that for recurrent inguinal hernia repair, the guidelines are not yet being observed to the extent required [52].…”

Section: Recurrent Inguinal Herniamentioning

confidence: 99%

“…The authors concluded that for recurrent inguinal hernia repair, the guidelines are not yet being observed to the extent required [52]. Paying heed to the guidelines, comparison of perioperative and 1-year outcome for laparo-endoscopic and open repair for primary versus recurrent male unilateral inguinal hernia showed significant differences to the disadvantage of the recurrent operation [53,54].…”

Section: Recurrent Inguinal Herniamentioning

confidence: 99%

See 1 more Smart Citation

Current Concepts of Inguinal Hernia Repair

2018

View full text Add to dashboard Cite

With more than 20 million patients annually, inguinal hernia repair is one of the most often performed surgical procedures worldwide. The lifetime risk to develop an inguinal hernia is 27-43% for men and 3-6% for women. In spite of all advances, 11% of all patients suffer from a recurrence and 10-12% from chronic pain following primary inguinal hernia repair. By developing evidence-based guidelines and recommendations, the international hernia societies aim to improve the outcome of inguinal hernia repair due to standardization of care. From a total of more than 100 different repair techniques for inguinal and femoral hernias, classified as tissue repair, open mesh repair, and laparo-endoscopic mesh repair, the new International Guidelines of the Hernia-Surge Group only recommend the totally extraperitoneal patch plasty (TEP), transabdominal preperitoneal patch plasty (TAPP), and Lichtenstein techniques. Since a generally accepted technique suitable for all inguinal hernias does not exist, surgeons should provide both an anterior open (Lichtenstein) and a posterior laparo-endoscopic (TEP or TAPP) approach option. The guidelines strongly recommend that surgeons tailor the treatment of inguinal hernias based on expertise, local/national resources, and patient- and hernia-related factors. A tailored approach in inguinal hernia repair should pay heed to the patient- and hernia-related factors, unilateral hernia in men and women, bilateral hernia, recurrent hernia, scrotal hernia, previous pelvic and lower abdominal surgery, severe cardiac or pulmonary comorbidities, and incarcerated hernia.

show abstract

Section: Recurrent Inguinal Herniamentioning

confidence: 99%

Section: Recurrent Inguinal Herniamentioning

confidence: 99%

Current Concepts of Inguinal Hernia Repair

2018

View full text Add to dashboard Cite

show abstract

“…While that approach assures the best outcome (4), even when these guidelines are followed a re-recurrence rate of 1–2% is seen on 1-year follow-up, with that rate rising further in the subsequent years (3). Accordingly, increasingly more patients will in the future seek treatment for re-recurrence after anterior and posterior mesh implantation in the groin.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Laparoscopy as Decision Tool for Re-recurrent Inguinal Hernia Treatment Following Open Anterior and Laparo-Endoscopic Posterior Repair

Köckerling

Schug-Paß

2017

Front. Surg.

View full text Add to dashboard Cite

IntroductionThe guidelines of the international hernia societies recommend posterior repair in laparo-endoscopic technique for recurrent inguinal hernia after open anterior mesh repair and, conversely, open anterior repair for recurrence after laparo-endoscopic primary repair. Even when these guidelines are followed, already 1 year after repair a re-recurrence rate of 1–2% must be expected, with that rate rising further in the subsequent years. Accordingly, increasingly more patients with re-recurrence after anterior and posterior mesh implantation must be treated, which constitutes a problem that to date has been investigated in only very few studies. Hence, there are no well-founded recommendations. This paper now presents a number of case reports aimed at identifying the role of explorative laparoscopy as decision tool for re-recurrent inguinal hernia treatment.Patients and methodsBased on three case reports the role of explorative laparoscopy as decision tool for re-recurrent inguinal hernia treatment is presented below.ResultsIn all the three cases described explorative laparoscopy played a key role as decision tool when deciding how best to treat re-recurrence after anterior and posterior inguinal hernia repair. In one case severe adhesions after robotic prostatectomy and in another case correct placement of the mesh in the posterior plane, adhesions from the cecum to the groin region and no definitive finding of a re-recurrence resulted in an open repair. In the third case, an insufficient laparoscopic posterior mesh placement made the re-recurrent TAPP procedure relatively easy.ConclusionExplorative laparoscopy is an important decision tool for re-recurrent inguinal hernia treatment to minimize the risks of the procedure for the patients.

show abstract

“…Recurrences after inguinal hernia repairs can occur even up to 50 years later [2]. In recent administrative data and registry analyses it was revealed that the proportion of recurrent repairs in the total collective of inguinal hernia repairs among men was 11.3-14.3% [3][4][5][6][7] and in women 7.0-7.4% [4,8]. By contrast, in systematic reviews and meta-analyses the recurrence rates were still far lower (1.2-3%) than those cited above since the included studies had a maximum follow-up time of 6 years [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

“…laparo-endoscopic (TEP, TAPP) following previous open anterior repair and anterior open (Lichtenstein) following previous laparo-endoscopic repair. However, to date that recommendation is not adequately applied [5] and results in significantly higher rates of second recurrences [5].…”

Section: Introductionmentioning

confidence: 99%

What is the outcome of re-recurrent vs recurrent inguinal hernia repairs? An analysis of 16,206 patients from the Herniamed Registry

Köckerling

Krüger

Gagarkin³

et al. 2020

Hernia

Self Cite

View full text Add to dashboard Cite

Introduction The proportion of recurrent repairs in the total collective of inguinal hernia repairs among men is 11.3-14.3% and among women 7.0-7.4%. The rate of re-recurrences is reported to be 2.9-9.2%. To date, no case series has been published on second and ≥ third recurrences and their treatment outcomes. Only case reports are available. Materials and methods In an analysis of data from the Herniamed Registry the perioperative and 1-year follow-up outcomes of 16,206 distinct patients who had undergone first recurrent (n = 14,172; 87.4%), second recurrent (n = 1,583; 9.8%) or ≥ third recurrent (n = 451; 2.8%) inguinal hernia repair between September 1, 2009 and July 1, 2017 were compared. Results The intraoperative complication rate for all recurrent repairs was between 1-2%. In the postoperative complications a continuous increase was observed (first recurrence: 3.97% vs second recurrence: 5.75% vs ≥ third recurrence 8.65%; p < 0.001). That applied equally to the complication-related reoperation rates (first recurrence: 1.50% vs second recurrence: 2.21% vs ≥ third recurrence 2.66; p = 0.020). Likewise, the re-recurrence rate rose significantly (first recurrence: 1.95% vs second recurrence: 2.72% vs ≥ third recurrence 3.77; p = 0.005). Similarly, the rate of pain requiring treatment rose highly significantly with an increasing number of recurrences (first recurrence: 5.21% vs second recurrence: 6.70% vs ≥ third recurrence 10.86; p = < 0.001). Conclusion The repair of re-recurrences in inguinal hernia is associated with increasingly more unfavorable outcomes. For the first recurrence the guidelines should definitely be noted. For a second and ≥ third recurrence diagnostic laparoscopy may help to select the best possible surgical technique.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

show abstract

Laparo-endoscopic versus open recurrent inguinal hernia repair: should we follow the guidelines?

Cited by 38 publications

References 33 publications

Current Concepts of Inguinal Hernia Repair

Current Concepts of Inguinal Hernia Repair

Diagnostic Laparoscopy as Decision Tool for Re-recurrent Inguinal Hernia Treatment Following Open Anterior and Laparo-Endoscopic Posterior Repair

What is the outcome of re-recurrent vs recurrent inguinal hernia repairs? An analysis of 16,206 patients from the Herniamed Registry

Contact Info

Product

Resources

About