reoccurring right side inguinal repair (done with TEP), to use open or TAPP?

[andrewY]

Thanks Dr. Shirin.

[drtowfigh]

Thanks for your questions. There is no correct single answer. The type of repair options for revisional surgery vary depending on each patient’s needs. For example, type of prior repair, reason for recurrence, risk factors for recurrence, size of recurrence, lifestyle, etc. We usually don’t place mesh directly over mesh.

[andrewY]

Thanks Good intensions, and Dr. Shirin.
Dr. Shirin, would you pls share if you do the recurrence repair for me, what procedure you will use? if you use open, what are the key steps u will use? will u remove the original mesh?

for the recurrences repair with open method, is it gonna be the same open procedure as the standard one? i.e. push back the content and suture the abdomen wall, and then place the mesh (this is my understanding of how open procure works: if in the future the abdomen wall is broken again/hole comes again, the mesh can still prevent the Intestine protrudes into inguinal canal, right?

I guess it will be difficult than the standard open one, as there is a mesh, then it will be not easy to push back content, suture the abdomen, etc.

@Good intensions, I don’t have mesh problem now.
Br,
Andrew

[drtowfigh]

Most recurrences from laparoscopic surgery are best addressed with open approach the second time.

That said, in the hands of an expert surgeon, a redo laparoscopic or robotic procedure may be feasible in some patients.

[Good intentions]

I have had two laparoscopic surgeries. One was TEP for mesh implantation, the other was TAPP for its explantation.

The tissues and structures in the area of the hernia are tied up with mesh after the first laparoscopic surgery. “Incorporated”. They can’t easily peel them apart anymore like they could during the first surgery. So a second surgery is more difficult, for either method. It’s a matter of choice for the surgeon on which method they feel will give the best results.

You should get more detail on what each doctor plans to do. Sometimes they leave the old mesh in and just put new mesh on top. If you had mesh problems in addition to the recurrence, you might end up with a repaired hernia but still not feeling right.

Good luck.