Journal Article

Inguinal hernia recurrence after laparoscopic mesh removal for chronic pain: a single-center experience with 11 years of practice

Rops, J. P., Slooter, G. D., Loos, M. J. A., Zwaans, W. A. R., van Dijk, W. A., Scheltinga, M. R. M., Chaoui, A. M.

2025

Overview

Introduction Up to 12% of patients undergoing minimally invasive inguinal hernia repair may develop chronic postoperative inguinal pain (CPIP), possibly explained by the presence of mesh. Recent studies reported that laparoscopic mesh removal is feasible and safe. However, the risk of a hernia recurrence is unknown. This observational study describes the rate of hernia recurrence and evolution in pain score following laparoscopic mesh removal for CPIP after preperitoneal inguinal hernia repair. Methods Prospectively collected questionnaires and operative notes of consecutive patients undergoing a laparoscopic mesh removal for CPIP in our center of expertise between November 2011 and July 2022 were studied. Pain scores were quantified using the Numeric Pain Rating Scale (NRS, 0–10). The presence of a hernia recurrence was based on patient history and clinical findings. Results A total of 89 patients underwent laparoscopic mesh removal, and data of 83 patients (93% response rate) were available for analysis. Median decrease in pain score (NRS) after mesh removal was 4 (range + 2 to − 9). After a median 4.3 years follow up period, a hernia recurrence was present in 18 patients (21.7%). Of these, eight were symptomatic requiring correction using a Lichtenstein repair with a favorable outcome whereas a wait-and-see approach was successfully followed in the remaining 10 patients. Conclusion Laparoscopic mesh removal for CPIP following preperitoneal inguinal hernia repair resulted in an inguinal hernia recurrence in one of five patients requiring remedial surgery in one in ten patients. This knowledge may inform the preoperative counseling process. Graphical abstract

• Publisher: Springer US,Springer Nature B.V
• Subject: Abdomen / Abdominal Surgery / Adult / Aged / Aged, 80 and over / Chronic pain / Chronic Pain - etiology / Device Removal - methods / Dissection / Endoscopy / Female / Gastroenterology / Gynecology / Hepatology / Hernia, Inguinal - surgery / Hernias / Herniorrhaphy - adverse effects / Herniorrhaphy - methods / Humans / Laparoscopy / Laparoscopy - methods / Male / Medical history / Medicine / Medicine & Public Health / Middle Aged / Pain Measurement / Pain, Postoperative - etiology / Patients / Proctology / Prospective Studies / Quality of life / Questionnaires / Recurrence / Standard of care / Surgeons / Surgery / Surgical Mesh