Endoscopic hernia surgery (TAPP) - The gold standard in treating recurrent hernias?

From April 1993 to December 1995 210 TAPP procedures were performed because of recurrent hernia. With the TAPP method there is no difference between primary and recurrent repair. All procedures in this study were done with general anaesthesia by senior surgeons. The learning curve shows a reduction of operation time (60 to 55 min) with increasing experience and a reduction in complications as well (total 4.3 %). Recurrence was observed in two cases. The reasons for these recurrences were technical failures during the previous repair. In both cases a second TAPP repair was carried out successfully. The main advantage of TAPP in recurrent hernia is that this method gives possibilities to avoid anterior scar tissue. Secondly tension-free repair can be combined with the benefit of the minimal access technique. For this reason, the TAPP procedure must be considered the method of choice in recurrent hernia repair.