关键词: 复发性腹股沟疝, 腹腔镜, 修补

Abstract: The treatment of recurrent inguinal hernias presents specific challenges. Both open and laparoscopic inguinal hernia repair (LIHR) demonstrates inferior outcomes compared to primary hernia repair. Current guidelines exhibit consensus regarding LIHR for recurrences following anterior repairs. However, the conventional preference of open surgery for recurrences after posterior repair has been questioned and challenged in recent years. Chinese expert consensus on key issues of laparoscopic inguinal hernia surgery emphasizes that such recurrent cases are no longer contraindications for LIHR and could be safely and more effectively performed by experienced surgeons. LIHR offers unique diagnostic advantages through intra-abdominal exploration, which cannot be replaced by other surgical procedures. Transabdominal preperitoneal (TAPP) repair is recommended as the preferred procedure, which could manage most recurrent cases. Conversion to open surgery should be considered for difficult situations. The existing mesh should be reutilized appropriately during LIHR and not removed unless in a specific scenario. The new meshes are tailored for local repair of the recurrence area instead of covering the entire myopectineal orifice. Surgeons are advised to utilize peritoneal folds or hernia sacs for a complete covering for the mesh, reserving intraperitoneal onlay mesh (IPOM) or transabdominal partially extraperitoneal (TAPE) techniques for specific cases. Emerging evidence suggests potential benefits from defect closure techniques and robotic-assisted platforms.

Key words: recurrent inguinal hernia, laparoscopy, repair