Minilaparoscopic transabdominal preperitoneal repair of recurrent hernias: results in 100 consecutives cases

Recurrent inguinal hernia repair is a demanding procedure, because of already weakened tissues and obscured and distorted anatomy with a recurrence rate as high as 40%. This retrospective study evaluated our experience with a minilaparoscopic transabdominal pre-peritoneal hernioplasty procedure to repair recurrent hernia. 100 recurrent hernias were repaired in 97 patients with miniTAPP procedure using trocars, optics and instruments< 5 mm in diameter (5 mm for optic and two trocars of 3 mm for struments). Long-term follow-up was available by examination in all patients. Median follow-up was 52 months (range, 28–100 months). There were 8 minor and 1 major complications and no mortality. All patients were satisfied with laparoscopy treatment at 3 month follow-up. No recurrences have occurred to date. Mini TAPP approach combines the advantages of tensionless posterior prosthetic hernioplasty covering all of the potential sites of recurrences (direct, indirect, and femoral) with the rapid rehabilitation afforded by mini skin incisions plus leads to less postoperative pain and discomfort, decreased postoperative analgesia requirements, thanks to the use of fibrin glue as mesh fixation which appears less harmfull than stapling, decreased convalescence time, and earlier return to day-to-day and strenuous activity. Our data show that miniTAPP hernioplasty is a highly effective method of repairing recurrent inguinal hernias with acceptable complication rates and all the advantages of a more mini-invasive technic in experienced hands and dedicated centers.