Felix EL. A unified approach to recurrent laparoscopic hernia repairs.
Surg Endosc 2001;
15:969-71. [PMID:
11443447 DOI:
10.1007/s004640080091]
[Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2000] [Accepted: 11/15/2000] [Indexed: 11/28/2022]
Abstract
BACKGROUND
The problem of recurrence after laparoscopic hernia repair is relatively new, and the best way to handle it remains uncertain. The question of whether an open approach, a laparoscopic approach, or some combination of techniques should be preferred has not yet been resolved. The purpose of this study was to determine if the laparoscopic approach could deal with the problem safely and successfully.
METHODS
A retrospective review was done of the cases performed at the Center for Hernia Repair by one surgeon between July 1991 and September 1999. Laparoscopic hernioplasties for hernias that had previously been repaired laparoscopically were analyzed. All remedial repairs were begun using a transabdominal approach.
RESULTS
Seventeen of 1960 hernias repaired were for failed laparoscopic repairs. Ten were repaired totally laparoscopically and two via an open approach with mesh, while five required a small anterior counterincision. There were no serious complications and one recurrence.
CONCLUSION
The laparoscopic transabdominal approach to failed laparoscopic repairs is feasible, safe, and reliable when used in combination with a modified anterior approach when appropriate.
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