464 Incidence of recurrent inguinal hernias and their repairs at a large DGH

Abstract

In the UK 100,000 hernia operations are performed annually – this includes umbilical/epigastric/incisional etc. Options of inguinal repair are either open or laparoscopic (TAPP vs TEP). Recurrence rates for Liechtenstein repairs are quoted as 5.6%. Median recurrence rates for TAPP repair are quoted as 2.3% and for TEP 0.6%. However, several meta-analyses comparing TEP/TAPP to open repairs found no significant difference in recurrence rates. At our trust, 331 inguinal hernia operations were performed between August 2021- August 2022 (post-COVID). The aim of this project was to look at the incidence of recurrent hernias and their initial repairs at our trust.

We obtained a list of all inguinal hernia repairs in our trust (across all sites) between August 2021- August 2022. We looked at the number of patients that underwent an operation for a recurrent hernia and whether that patient’s primary repair was done laparoscopically or open.

76% of total inguinal hernia repairs were performed open, compared to 24% laparoscopic repairs (72% TEP repairs). About 10% of total repairs were for recurrent hernias. 56% of those had a primary open repair and 44% had a primary laparoscopic repair. 75% of the recurrent hernias underwent a second open repair and 25% underwent a second laparoscopic repair.

We aim to repeat this study with more data (i.e. looking at pre-COVID years) and encourage our laparoscopic hernia surgeons to look into their own practice.