Medical Science Research Bulletin

Recurrent inguinal hernia remains a significant clinical challenge despite advances in hernia surgery. The incidence of recurrence following primary inguinal hernia repair ranges from 1% to 15%, depending on patient-related factors, surgical technique, mesh utilization, and duration of follow-up. Understanding the factors associated with recurrence and optimal management strategies is therefore essential for surgeons involved in abdominal wall reconstruction. Multiple risk factors have been implicated in hernia recurrence. Patient-related factors include advanced age, obesity, smoking, diabetes mellitus, malnutrition, collagen disorders, chronic cough, constipation, and activities associated with increased intra-abdominal pressure. Surgical factors such as inadequate dissection, improper mesh placement or fixation, tension on the repair, infection, and surgeon inexperience also contribute significantly to recurrence. The management of recurrent inguinal hernia is a tailored approach based on index repair. For recurrence after an anterior repair, a posterior laparoscopic approach, including transabdominal preperitoneal (TAPP) or totally extraperitoneal (TEP) repair, is generally preferred. Conversely, recurrent hernias following a posterior repair are commonly managed through an open anterior mesh repair. This review summarizes the current evidence regarding the incidence, risk factors, and contemporary management of recurrent inguinal hernia in adults.

Recurrence, Anterior approach, TAPP, TEP, Preperitoneal repair, Open repair, Posterior approach.

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