Recurrent inguinal hernia treated by classical hernioplasty

J. N. Ijzermans, H. de Wilt, W. C. Hop and H. Jeekel
Department of Surgery, University Hospital Dijkzigt, Rotterdam, The Netherlands.

The treatment of recurrent inguinal hernia by classical hernioplasty, ie, via the anterior approach and using endogenous tissue for repair, was evaluated in 163 patients operated on between 1980 and 1987. One hundred fifteen patients had a first recurrence and 48 had a multiple recurrence; 58% were of the direct type; 30% were of the indirect type; 7% were of the combined type; and 5% were not defined. In 1989 a questionnaire was sent to all patients; those indicating symptoms of recurrence underwent further examination. There was a mean follow-up of 52 months and a total follow-up period of 706 years. Thirty-seven patients had a repeated recurrence with a cumulative recurrence rate of 16%, 21%, and 23%, after 1, 2, and 5 years, respectively. Increase of age and time passed since the last repair reduced the recurrence rate. Increased abdominal pressure, type of anesthesia or surgical technique, and wound hematoma had no effect. It is concluded that the technique of classical hernioplasty as such may be unsuitable for repair of recurrent inguinal hernias.