Location of recurrent groin hernias at TEP after Lichtenstein repair: a study based on the Swedish Hernia Register

Abstract

Purpose: To investigate which type of hernia that has the highest risk of a recurrence after a primary Lichtenstein repair. Methods: Male patients operated on with a Lichtenstein repair for a primary direct or indirect inguinal hernia and with a TEP for a later recurrence, with both operations recorded in the Swedish Hernia Register (SHR), were included in the study. The study period was 1994–2014. Results: Under the study period, 130,037 male patients with a primary indirect or direct inguinal hernia were operated on with a Lichtenstein repair. A second operation in the SHR was registered in 2236 of these patients (reoperation rate 1.7 %). TEP was the chosen operation in 737 in this latter cohort. The most likely location for a recurrence was the same as the primary location. If the recurrences change location from the primary place, we recognized that direct hernias had a RR of 1.51 to having a recurrent indirect hernia compared to having a direct recurrence after an indirect primary hernia repair. Conclusions: Recurrent hernias after Lichtenstein are more common on the same location as the primary one, compared to changing the location.