Successful laparoscopic transabdominal preperitoneal repair of recurrent inguinal hernia of the bladder following bilayer mesh use: A case report.

INTRODUCTION

The effectiveness of laparoscopic repair for recurrent inguinal hernias has been previously reported; however, recurrence following bilayer mesh use has rarely been reported. We report a case of successful total laparoscopic repair of a recurrent inguinal hernia of the bladder in which a bilayer mesh was used for the initial direct inguinal hernia.

PRESENTATION OF CASE: An 80-year-old man underwent hernia repair using a bilayer mesh for a right direct hernia 12 years ago. Computed tomography revealed a malignant neoplasm of the pancreas and an asymptomatic recurrence of a right direct hernia of the bladder. We performed a laparoscopic distal pancreatectomy and splenectomy for the malignant pancreatic neoplasm. Postoperatively, the patient complained of right inguinal pain and frequent urination. Therefore, 2 months after the pancreatic surgery, we decided to perform laparoscopic repair of the right recurrent inguinal hernia of the bladder. Regardless of severe adhesions attributed to the bilayer mesh in the preperitoneal space, we could safely and definitely complete the laparoscopic transabdominal preperitoneal repair. No postoperative complications were observed, and the patient was discharged on postoperative day 2.

DISCUSSION: In cases of recurrence following hernia repair using a bilayer mesh, both laparoscopic and anterior approaches may be challenging owing to the presence of adhesions.

CONCLUSION

Definite intraoperative identification of the urinary bladder and mesh placement in the hernia orifice are necessary for an effective laparoscopic approach. Laparoscopic hernia repair may be feasible in cases of recurrence following bilayer mesh use.