Pitfalls of laparoscopic Re-TAPP in recurrent inguinal hernia repair-a plea for extended preoperative diagnostic.

According to international guidelines, recurrent inguinal hernia should be treated by a surgical approach opposing of the primary strategy (anterior-posterior or posterior-anterior). However, recent evidence demonstrates feasibility and safety of re-laparoscopic repair of recurrent inguinal hernia after primary laparoscopy. For such a strategy, correct identification of anatomical structures is challenging, but absolutely crucial for a satisfactory postoperative result. This case of an unrecognized sliding hernia of the sigmoid colon during re-laparoscopy highlights that a precise physical examination as well as an extended preoperative radiological workup (ultrasound, computed tomography and/or magnetic resonance imaging of the abdomen and pelvis) should be considered prior to re-laparoscopy of recurrent inguinal hernia.