Special attention – treatment of recurrent hernia

  There are many different types of hernia repairs, which are broadly divided into two categories: traditional suture repair and tension-free hernia repair. Postoperative recurrence is more common in the traditional approach, about 10-30%, while tension-free repair is the use of a hernia patch, which can reduce recurrence to less than 1%, as reported by some doctors. However, postoperative recurrence is still a headache for doctors and patients because inguinal hernia repair is an anatomical operation and the success of the operation depends on whether the surgeon can clearly isolate the anatomical relationship of the corresponding defect. For patients with recurrence, the local anatomy has been harassed by the last or even the last few operations and it is very difficult to operate again, which is why there are patients who come to our department for 9 times with hernia recurrence!  In recent years, tension-free hernia repair is an operation using patches that has been carried out in large numbers in China. Due to the many controversies and shortcomings of the early operation techniques and concepts, although this operation has greatly reduced the recurrence rate, there are still some recurrence cases gradually appearing, and it is very important to pay attention to these recurrence patients, which are treated with patches, and the local scar formation and dense adhesions between patches make After summarizing the surgical experience of many patients, we have applied laparoscopic techniques to explore recurrent hernias from the abdominal cavity and perform individualized repair with very satisfactory results, basically eliminating the possibility of recurrence and reoccurrence, and has become a preferred option for the treatment of recurrent hernias.        In case of recurrence of recurrent hernia, whether after traditional repair or after patching, the patient’s pubic foramen area is anatomically weak and there is a possibility of recurrence due to the formation of postoperative scar. The surgical approach of laparoscopic technique is the posterior approach, which involves drilling into the abdominal cavity and exploring the location and size of the hernia defect from the inside, which is performed bilaterally and allows the detection and management of hidden hernias. The defect is repaired under direct visualization from inside the abdominal cavity, using a lighter flat material to cover the defect from the inside and spreading and fixing it internally beforehand for the purpose of radical cure.  Laparoscopic hernia repair is a minimally invasive procedure with minimal damage and quick recovery, and because it is performed under direct vision, recurrent hernias are greatly reduced after surgery. It also avoids and reduces the problem of postoperative pain and is a very advanced treatment for hernia. For a skilled laparoscopic surgeon, the time and cost of a common inguinal hernia surgery with laparoscopy is basically the same as an open surgery with local anesthesia, but the postoperative results, especially the long-term outcome, are clearly superior.