• Thue Bisgaard, Morten Bay-Nielsen, and Henrik Kehlet.
• The Juliane Marie Centre, Rigshospitalet, Copenhagen, Denmark. thuebisgaard@tdcadsl.dk
• Ann. Surg. 2008 Apr 1; 247 (4): 707-11.

ObjectivesWe analyze, on a nationwide basis, the risk of re-reoperation with reference to previous inguinal hernia repair technique.Summary Background DataOperation for a recurrent inguinal hernia is common and the risk of re-recurrence is high. There are no large-scale data evaluating the surgical strategy and results after recurrent inguinal hernia repairs.MethodsProspective recording of all primary and subsequent recurrent inguinal hernia repairs from January 1, 1998 to December 31, 2005, in the national Danish Hernia Database, using the reoperation rate as a proxy for recurrence. The re-reoperation rate was analyzed with reference to the technique of primary and recurrent inguinal hernia repair.ResultsAfter 67,306 primary hernia repairs there were 2117 reoperations (3.1%) and 187 re-reoperations (8.8%). The cumulated re-reoperation rate after primary Lichtenstein repair (n = 1124) was significantly reduced after laparoscopic operation for recurrence (1.3% (95% CI: 0.4-3.0)) compared with open repairs for recurrence (Lichtenstein 11.3% (8.2-15.2), nonmesh 19.2% (14.0-25.4), mesh (non-Lichtenstein) 7.2% (4.0 - 11.8)). After primary nonmesh (n = 616), non-Lichtenstein mesh (n = 277), and laparoscopic repair (n = 100) there was no significant difference in re-reoperation rates between a laparoscopic repair and all open techniques of repair for recurrence.ConclusionLaparoscopic repair is recommended for reoperation of a recurrence after primary open Lichtenstein repair.

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