Managing Recurrence After Laparoscopic Inguinal Hernia Repair: What to Expect

Postoperative care for inguinal hernia repair?

About three years ago, I had surgery for a right inguinal hernia using laparoscopic extraperitoneal surgery with a synthetic mesh.
About a year after the surgery, I noticed a bulge on the right side of my groin again, which has become more pronounced and sometimes painful, indicating a possible recurrence.
If I need to undergo surgery again, what method will be used? Will it be traditional open surgery? Will the original synthetic mesh need to be removed? Will the surgery be difficult to manage, considering I have only had this one surgery?

Xxx, 60~69 year old female. Ask Date: 2023/06/23

Dr. Xu Kaixi reply Surgery

If a recurrent hernia repair is performed using laparoscopic extraperitoneal surgery, consideration may be given to using traditional methods for subsequent surgery.
Theoretically, the original mesh would remain in place, and the procedure would follow traditional techniques.
The difficulty of the surgery would be assessed based on the condition of the recurrence.

Reply Date: 2023/06/23

More Info

Managing recurrence after laparoscopic inguinal hernia repair can be a complex issue, especially considering your history of previous surgery and the use of a mesh implant. When a hernia recurs, it typically means that the tissue has re-protruded through the abdominal wall at or near the site of the original repair. This can happen for various reasons, including tension on the repair site, inadequate healing, or even the natural weakening of the abdominal wall over time.

1. Surgical Approach: If you are experiencing a recurrence of your inguinal hernia, the surgical approach may vary depending on the specifics of your case. In many instances, surgeons may opt for an open surgical repair instead of laparoscopic repair for recurrent hernias. This is primarily because open surgery allows for better visualization and access to the area, which can be crucial when dealing with scar tissue from previous surgeries. However, laparoscopic techniques can still be employed, especially if the recurrence is not complicated by significant scar tissue or other factors.

2. Mesh Considerations: Regarding the existing mesh, it is generally not removed unless there are complications such as infection, significant pain, or if the mesh is causing problems. In most cases, the surgeon will leave the original mesh in place and reinforce the repair with additional mesh or sutures. The decision to remove the mesh will depend on the surgeon's assessment during the procedure.

3. Surgical Difficulty: The difficulty of the surgery can vary. If the recurrence is straightforward and there is minimal scar tissue, the procedure may be relatively uncomplicated. However, if there is extensive scar tissue or other complications, it may make the surgery more challenging. Surgeons often assess the situation during the operation to determine the best course of action.

4. Recovery and Expectations: Post-operative recovery from a hernia repair can vary based on the surgical technique used and the individual’s overall health. Generally, patients can expect some discomfort and swelling in the area post-surgery, which should gradually improve over time. It's essential to follow your surgeon's post-operative care instructions, including activity restrictions and pain management strategies.

5. Follow-Up Care: After surgery, regular follow-up appointments are crucial to monitor the healing process and ensure that the hernia does not recur again. If you experience any unusual symptoms, such as severe pain, swelling, or changes in bowel habits, it is essential to contact your healthcare provider promptly.

In conclusion, managing a recurrence of an inguinal hernia after laparoscopic repair involves careful consideration of the surgical approach, the status of the existing mesh, and the individual patient's circumstances. Open surgery is often preferred for recurrent cases, but laparoscopic techniques may still be viable. The complexity of the surgery will depend on the extent of scar tissue and other factors. Always consult with your surgeon to discuss the best options tailored to your specific situation.

Similar Q&A

Understanding Hernia Recurrence: Symptoms and Diagnosis After Surgery

Hello, doctor! I had a laparoscopic hernia repair surgery two months ago. Last Wednesday, I used my core abdominal strength to support a motorcycle that was about to fall. As a result, I've been experiencing pain this week, but there is no swelling. Is there a chance of recu...

Dr. Li Xinyi reply Urology
It is possible to experience pain this week, and if there is a recurrence, it may be due to a re-protrusion. If there are concerns related to the surgical method, it is advisable to return to the original urology department for examination and follow-up.

Post-Surgery Hernia Recovery: Key Questions and Concerns Addressed

Hello, after you answer me, I still have some questions. Since I currently only have issues on the right side (18 years old, right side for about 2 years), does this mean that the recurrence rate on the left side is very high? (All males in my family have bilateral issues.) I hav...

Dr. Ke Fangxu reply Surgery
Although young individuals with inguinal hernias often present with bilateral cases, it is not always the case. The likelihood of recurrence on the left side is higher compared to the general population. Maintaining a regular exercise routine is beneficial; however, weight traini...

Post-Surgery Concerns After Varicocele Repair: What to Expect

Hello, Dr. Hsu. I have undergone two surgeries for varicocele. The first was a left-sided high ligation, but after some time, I started experiencing abdominal pain, and follow-up revealed a recurrence. I read that the recurrence rate for microsurgery is low, so I underwent bilate...

Dr. Xu Weikai reply Urology
Ahan: Hello. 1. It's possible, but the time is too short, and further follow-up is needed. 2. Generally, a recommendation of 6 months is advised. 3. Reducing abdominal pressure should help improve the reflux issue. If there are any unclear points, feel free to ask again, and...

Understanding Recurrence Risks After Traditional Hernia Repair Surgery

Hello, doctor. I am 30 years old. When I was younger, I had an indirect inguinal hernia and underwent traditional suture surgery at around 15 years old (with no need for suture removal post-operation). Recently, while helping to lift heavy objects, I felt a slight pulling sensati...

Dr. Du Shixi reply Urology
Hello: There are two types of hernias, and regardless of the surgical method used, there is always a possibility of recurrence. Even after surgery, if you return to normal activities and exert pressure on your abdomen, it can still recur. Some cases may be indirect hernias that r...