Recurrent hernia surgery
If the groin hernia recurs then any subsequent re-repair is far more complex. Once a repair has been performed the anatomy of the groin is permanently changed with dense scarring around the groin structures. This is why it is so important to reduce recurrence rates to the lowest level possible. The scarring found makes identification of the anatomy far more difficult and hence complication rates are far higher. Nerves are more commonly damaged and the risk of injuring the blood supply to the testicle is not insignificant (up to 5% in some series). In some cases this can lead to loss of the testicle altogether!
Repair of recurrent groin hernias needs to be done by a very experienced hernia surgeon and it is in this area that ‘keyhole ‘surgery is particularly helpful (see below). Conventional open or non-key hole approaches to repairing recurrent groin hernias involves reopening the old scar (usually under general anaesthetic) and placing a mesh over the defect. This can also be done as a day case but may require an overnight stay. Post operatively the doctor needs to be wary of complications particularly in men where the testicle blood supply may be in jeopardy. Any concern regarding the state of the testicle on the side of the operation should be reported to the surgeon immediately. Otherwise the post operative recovery is the same as for ‘first time’ repairs.
