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TIPP - Transinguinal Preperitoneal Hernia Repair: a Suitable Solution for a Recurrent Groin Hernia in Cases with Already Implanted Prosthetic Material and in Cases with Chronic Inguinodynia Syndrome

M. Radionov, D. D., M. Momchilova


The authors review the challenges in the operative treatment of recurrent groin hernia in cases with already implanted, once or more times, prosthetic material and recurrences, and in cases of clinically manifested `chronic inguinodynia syndrome`. A literature review and physiological-biomechanical analysis are done, as well as substantiation of the preperitoneal groin repair with prosthetic material and our own experience which includes 57 transinguinal preperitoneal mesh repairs of the MPO with synthetic prosthetic material for a tree-year period (2013-2015) is shared. The operated patients are retrospectively analyzed by age, gender and term of the operation (elective/urgent). Indication for operative treatment in 23 cases was the presence of recurrent hernia after a classic hernia repair, in 29 others - the presence of a recurrence after synthetic mesh hernia repair, and a clinical manifestation of `chronic inguinodynia syndrome` after implanted in the past synthetic prosthetic material in 5 cases. The patients were assessed pre-operatively according to the type of the hernia, the recurrence sequence, the habitual particularities and the physical activities. The patho-morphological alterations in the MPO were assessed intra-operatively. In 27 cases (including these with `chronic inguinodynia syndrome`), the implanted in the past prosthetic material was excised and removed `in toto` and in the remaining 7 cases, it was partially resected. The duration of the operations varied - 40-80 min. (the average was 57 min.). No intra-operative complications were observed, the early postoperative ones were 8.77%, and all of them were successfully treated conservatively. The average postoperative stay was 1.72 days (1 to 5 days). The patients were followed up for periods between 3 and 24 months.


Keywords: groin hernia, hernia repair, TIPP, preperitoneal mesh repair, recurrent hernia



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About The Authors

M. Radionov

D. D.

M. Momchilova

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