Single-Incision Totally Extraperitoneal Inguinal Hernia Repair After Previous Inguinal Hernia Repair

Introduction: To evaluate the feasibility and safety of single-incision laparoscopic surgery for totally extraperitoneal repair (SILS-TEP) after previous open inguinal hernia repair. Materials and Methods: This prospective study included 372 consecutive patients undergoing SILS-TEP for inguinal hernia between January 2011 and December 2015 at Osaka Police Hospital. The outcomes of the patient after previous open inguinal hernia repair were compared with those of the control patients. Results: In total, 22 patients (6%, 22/372) undergoing SILS-TEP after previous inguinal hernia repair were included in this study. There were no significant differences in patients' characteristics between the 2 groups. There were no significant differences between the 2 groups in operative time, bleeding volume, and postoperative hospital stay. The conversion rate to a different procedure was significantly higher in the study group than in the control group [14% (3/22) vs. 3% (10/350)], respectively (P < 0.05). Postoperative complications were seen in 23% (5/22) of the patients in the study group and 11% (39/350) of the patients in the control group (P= 0.1). Nonfatal pulmonary embolism was seen in 1 patient (0.2%, 1/350) without appreciable previous history of the patients in the control group. No other major complications or hernia recurrences were observed during the follow-up period in either group. Conclusions: SILS-TEP with good cosmetic outcomes for patients with previous inguinal hernia surgery could be safely performed with acceptable morbidity though the conversion rate to a different procedure might be higher. History of previous inguinal hernia surgery alone should not be a contraindication to SILS-TEP.