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Causes of recurrence in laparoscopic inguinal hernia repair

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A Correction to this article was published on 27 September 2018

This article has been updated

Abstract

Purpose

Recurrence after laparoscopic inguinal herniorrhaphy is poorly understood. Reports suggest that up to 13% of all inguinal herniorrhaphies worldwide, irrespective of the approach, are repaired for recurrence. We aim to review the risk factors responsible for these recurrences in laparoscopic mesh techniques.

Methods

A search of the Medline, Embase, Science Citation Index, Current Contents and PubMed databases identified English language, peer reviewed articles on the causes of recurrence following laparoscopic mesh inguinal herniorrhaphy published between 1990 and 2018. The search terms included ‘Laparoscopic methods’, ‘Inguinal hernia; Mesh repair’, ‘Recurrence’, ‘Causes’, ‘Humans’.

Results

The literature revealed several contributing risk factors that were responsible for recurrence following laparoscopic mesh inguinal herniorrhaphy. These included modifiable and non-modifiable risk factors related to patient and surgical techniques.

Conclusions

Recurrence can occur at any stage following inguinal hernia surgery. Patients’ risk factors such as higher BMI, smoking, diabetes and postoperative surgical site infections increase the risk of recurrence and can be modified. Amongst the surgical factors, surgeon’s experience, larger mesh with better tissue overlap and careful surgical techniques to reduce the incidence of seroma or hematoma help reduce the recurrence rate. Other factors including type of mesh and fixation of mesh have not shown any difference in the incidence of recurrence. It is hoped that future randomized controlled trials will address some of these issues and initiate preoperative management strategies to modify some of these risk factors to lower the risk of recurrence following laparoscopic inguinal herniorrhaphy.

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Change history

  • 27 September 2018

    In the original publication, affiliation 3 was incorrectly published for the author ‘Darius Ashrafi’. The correct affiliation should read as ‘Department of Surgery, Sunshine Coast University Hospital, Birtinya, QLD, Australia.

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Authors and Affiliations

  1. Sir Charles Gairdner Hospital, Perth, Australia

    Manjunath Siddaiah-Subramanya

  2. Mayne Medical School, University of Queensland, Brisbane, QLD, Australia

    Manjunath Siddaiah-Subramanya, Darius Ashrafi & Muhammed Ashraf Memon

  3. Department of Surgery, Sunshine Coast University Hospital, Buderim, QLD, Australia

    Darius Ashrafi

  4. South East Queensland Surgery (SEQS) and Sunnybank Obesity Centre, Sunnybank, QLD, Australia

    Breda Memon

  5. Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia

    Muhammed Ashraf Memon

  6. School of Agricultural, Computing and Environmental Sciences, International Centre for Applied Climate Science, University of Southern Queensland, Toowoomba, QLD, Australia

    Muhammed Ashraf Memon

  7. Faculty of Health and Social Science, Bolton University, Bolton, Lancashire, UK

    Muhammed Ashraf Memon

  8. School of Medicine, Griffith University, Nathan, QLD, Australia

    Manjunath Siddaiah-Subramanya

  9. South East Queensland Surgery and Sunnybank Obesity Centre, McCullough Centre, Suite 9, 259 McCullough Street, Sunnybank, QLD, 4109, Australia

    Muhammed Ashraf Memon

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  1. Manjunath Siddaiah-Subramanya
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  2. Darius Ashrafi
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  3. Breda Memon
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  4. Muhammed Ashraf Memon
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Correspondence to Muhammed Ashraf Memon.

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Siddaiah-Subramanya, M., Ashrafi, D., Memon, B. et al. Causes of recurrence in laparoscopic inguinal hernia repair. Hernia 22, 975–986 (2018). https://doi.org/10.1007/s10029-018-1817-x

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