What question did this study set out to answer?

This study compares the outcomes of repeat endoscopic repair (ReTEP) and Lichtenstein technique for recurrent inguinal hernias following previous laparoendoscopic repair.

March 18, 2026Open Access

Redo TEP in recurrent inguinal hernia After TEP/TAPP: Outcomes and feasibility

Key Points

This study compares the outcomes of repeat endoscopic repair (ReTEP) and Lichtenstein technique for recurrent inguinal hernias following previous laparoendoscopic repair.
Retrospective analysis of intra- and postoperative morbidity
Prospective assessment of symptoms and quality of life
Clinical and ultrasound examinations conducted
Comparison made between 48 ReTEP and 45 Lichtenstein surgeries
Conversion from ReTEP to Lichtenstein occurred in 27.3% of cases
No significant differences in complications between ReTEP and Lichtenstein
Lichtenstein demonstrated superior outcomes in reduced foreign body sensation and pain
Higher rates of second recurrences noted after ReTEP compared to Lichtenstein

Abstract

The optimal management of recurrent inguinal hernia following previous laparoendoscopic repair lacks robust scientific evidence and varies across guidelines. Due to a paucity of data, the European Hernia Society currently recommends open anterior repair for the management of recurrent inguinal hernias after a previous laparoendoscopic repair, based solely on expert opinion. However, repeat endoscopic repair can yield favorable outcomes in experienced hands. This study aimed to compare patient outcomes between repeat endoscopic repair (ReTEP) and the Lichtenstein technique for recurrent hernias after initial TAPP or TEP. Adult patients undergoing surgery for first recurrence after laparoendoscopic repair were included. Intra- and postoperative morbidity was analyzed retrospectively, and symptoms and quality of life were assessed prospectively using clinical and ultrasound examination, the Carolinas Comfort Scale (CCS), and the COMI (Core Outcome Measurement Index)-Hernia questionnaire. Between January 2012 and March 2020, the center performed 48 ReTEPs and 45 Lichtenstein hernioplasties for the first recurrence of inguinal hernia after primary endoscopic surgery. Both groups were generally comparable in terms of age, BMI and intrinsic perioperative risk factors. The rate of conversion from ReTEP to Lichtenstein procedure was 27,3%, remained consistent over the years and showed no correlation with surgeon’s expertise. There were no statistically significant differences in the frequency and severity of complications between ReTEP and Lichtenstein. The Lichtenstein procedure was significantly superior in the categories “foreign body sensation” and “pain” assessed using the CCS and the second recurrencies were more frequently observed after ReTEP. The findings support the expert suggestion of HerniaSurge group regarding the change of procedure for managing recurrent inguinal hernia following initial endoscopic surgery. In this case the Lichtenstein operation should be considered.

Mark Helpful

Bookmark

Relay

View Full Paper