Reply To: Patterns of recurrence associated with specific types of inguinal hernia repair

[Good intentions]

It is saying that the type of recurrence is indirect more often for laparoscopic. The type, not the quantity. In other words, the surgeon is more likely to find an indirect recurrence in a patient that had laparoscopic surgery than in a patient that had open mesh or Shouldice.

The terminology is not very good in that strictly interpreting “recurrence” should mean that the same type of hernia re-happened. If the patient started with a direct hernia then came back with an indirect hernia that would, strictly speaking, be a new hernia. Not a recurrence. “Recurrence” is imprecise.

They also take the lax approach of, as far as can be told from the short summary, lumping all types of lap surgery and all types of mesh in to one pile of “lap mesh”. It seems wasteful to compile all of that data then do such a poor job of learning from it.

It is interesting though that Dr. Netto, who seems to have the urge to get involved in the hernia repair narrative, chose this topic to research. Trying to define the type of recurrence (or occurrence) to be expected from the type of repair. Not really clear why he thought that was important.