Single-port onlay mesh repair of recurrent XXXX after failed anterior and laparoscopic repairs.

@entity1 @entity362 @entity302 @entity547 @entity169 @entity1118
BACKGROUND AND OBJECTIVES: Despite the exponential increase in the use of laparoscopic inguinal herniorrhaphy, overall recurrence rates have remained unchanged. Therefore, a growing number of @entity1 are presenting with recurrent @entity547 after conventional anterior and laparoscopic repairs have failed. This study reports our experience with @entity302 ( @entity302 ) intraperitoneal onlay mesh (IPOM) repair of these @entity547 . METHODS: @entity1 referred with two or more recurrences of @entity169 underwent @entity302 -IPOM from November 1, 2009, to June 24, 2014. A 2.5-cm infraumbilical incision was made, and an @entity302 port was placed intraperitoneally. Modified dissection techniques were used: chopstick and inline dissection, 5.5-mm/52-cm/30   angled laparoscope, and conventional straight dissecting instruments. The peritoneum was incised above the pubic symphysis, and dissection was continued laterally and proximally, raising the inferior flap below the previous extraperitoneal mesh while reducing any direct, indirect, femoral, or @entity362 before placement of antiadhesive mesh, which was fixed to the pubic ramus, as well as superiorly, with nonabsorbable tacks before the inferior border was fixed with fibrin sealant. The inferior peritoneal flap was then tacked back onto the mesh. RESULTS: Nine male @entity1 underwent @entity302 -IPOM. Their mean age was 53 years and mean body mass index was 26.8 kg/m(2). Mean mesh size was 275 cm(2). Mean operation time was 125 minutes, with a hospital stay of 1 day. The umbilical scar length was 23 mm at the 6-week follow-up. There were no intra-/postoperative complications, port-site @entity547 , @entity1118 , or recurrence of the @entity547 during a mean follow-up of 24 months. CONCLUSION: @entity169 recurring after two or more failed conventional anterior and laparoscopic repairs can be safely and efficiently treated with @entity302 -IPOM.
