Successful mesh plug repair using a hybrid method for recurrent inguinal hernia after laparoscopic transabdominal preperitoneal approach: A case report

Rina Kikugawa; Shingo Tsujinaka; Sawako Tamaki; Tsutomu Takenami; Ryo Maemoto; Rintaro Fukuda; Nobuyuki Toyama; Toshiki Rikiyama

doi:10.1016/j.ijscr.2019.05.017

Successful mesh plug repair using a hybrid method for recurrent inguinal hernia after laparoscopic transabdominal preperitoneal approach: A case report

Int J Surg Case Rep. 2019:59:70-72. doi: 10.1016/j.ijscr.2019.05.017. Epub 2019 May 10.

Authors

Rina Kikugawa¹, Shingo Tsujinaka², Sawako Tamaki³, Tsutomu Takenami⁴, Ryo Maemoto⁵, Rintaro Fukuda⁶, Nobuyuki Toyama⁷, Toshiki Rikiyama⁸

Affiliations

¹ Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847, Amanumacho, Omiya, Saitama-shi, Saitama, 330-8503, Japan. Electronic address: rinamorita@nifty.com.
² Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847, Amanumacho, Omiya, Saitama-shi, Saitama, 330-8503, Japan. Electronic address: tsujinakas@omiya.jichi.ac.jp.
³ Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847, Amanumacho, Omiya, Saitama-shi, Saitama, 330-8503, Japan. Electronic address: s.tamaki@jichi.ac.jp.
⁴ Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847, Amanumacho, Omiya, Saitama-shi, Saitama, 330-8503, Japan. Electronic address: takenami@surg.med.tohoku.ac.jp.
⁵ Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847, Amanumacho, Omiya, Saitama-shi, Saitama, 330-8503, Japan. Electronic address: maemoto@jichi.ac.jp.
⁶ Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847, Amanumacho, Omiya, Saitama-shi, Saitama, 330-8503, Japan. Electronic address: r-fukuda@jichi.ac.jp.
⁷ Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847, Amanumacho, Omiya, Saitama-shi, Saitama, 330-8503, Japan. Electronic address: ntoyama@omiya.jichi.ac.jp.
⁸ Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847, Amanumacho, Omiya, Saitama-shi, Saitama, 330-8503, Japan. Electronic address: trikiyama@jichi.ac.jp.

Abstract

Introduction: The HerniaSurge Group and the European Hernia Society guidelines recommend an anterior approach to treat recurrent inguinal hernias after a failed posterior approach. The hybrid method combining explorative laparoscopy and anterior open approach can provide the benefits of both approaches.

Presentation of case: A 79-year-old man presented with a recurrent inguinal hernia after primary repair for an indirect hernia using the laparoscopic transabdominal preperitoneal approach (TAPP) 5 years ago. The indirect hernia formed inferior to the lower edge of the previous mesh was diagnosed under laparoscopy. The hernia defect (2 cm) was fixed using a mesh plug via the anterior approach. Appropriate mesh overlap was confirmed using laparoscopy.

Discussion: This minimally invasive method enabled us to choose the best treatment for recurrent hernia and prevent chronic pain due to possible nerve damage caused by extended dissection of the scar tissue. Furthermore, the final confirmation step using laparoscopy assures complete coverage of all defects within the myopectineal orifice.

Conclusion: This hybrid method facilitates the choice of an optimal approach for the treatment of recurrent hernia and may reduce surgical complications and re-recurrence rate.

Keywords: Hybrid method; Mesh plug; Recurrent inguinal hernia.