Featured Article| Volume 225, ISSUE 2, P252-257, February 2023

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Laparoscopic and robotic inguinal hernia repair are safe and effective after prior pelvic or low abdominal surgery


      • Prior low abdominal or pelvic surgery increases risk of inguinal hernia.
      • Inguinal hernia repair (IHR) after prior pelvic surgery is complicated by scarring.
      • Minimally invasive IHR is safe compared to an open approach after prior surgery.
      • Laparoscopic IHR provides a faster recovery than open surgery.
      • Patient satisfaction is equivalent regardless of IHR surgical approach.



      The ideal approach to inguinal hernia repair (IHR) after prior pelvic or low abdominal surgery is not agreed upon. We compared safety and outcomes of IHR between open, laparoscopic, and robotic approaches.


      This retrospective review of a prospective database analyzed demographic, perioperative, and quality of life data for patients who underwent IHR after pelvic or low abdominal surgery.


      286 qualifying patients underwent IHR between 2008 and 2020; 119 open, 147 laparoscopic, and 20 robotic. Laparoscopic repair led to faster cessation of narcotics and return to ADLs than open repair (all p <0.05). Post-operative complications, 30-day readmission, recurrences, and quality of life outcomes were equivalent, except less pain at 3-weeks post-op in the minimally invasive groups, p < 0.01.


      Minimally invasive IHR after prior pelvic or low abdominal surgery is safe compared to an open approach. Laparoscopic repair provides faster recovery, yet patient satisfaction is equivalent regardless of surgical approach.



      IHR (Inguinal Hernia Repair), MIS (Minimally Invasive Surgery), SOMS (Surgical Outcomes Measurement System), CCS (Carolinas Comfort Scale), TAPP (Transabdominal Preperitoneal), TEP (Totally Extraperitoneal)
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