title: Totally extraperitoneal (TEP) hernia repair after an original TEPIs it safe, and is it even possible?
abstract: BACKGROUND
  There are only scant published reports of totally extraperitoneal (TEP) repair of recurrence after a primary TEP procedure. Furthermore, at least two authors have made the statement that such an operation is virtually impossible.
  
  
  METHODS
  We have been performing TEP repair of recurrence after TEP since we 1996, and here we present a retrospective review of our experience with the procedure. We employ a method not varying greatly from the standard TEP done for primary hernia.
  
  
  RESULTS
  All cases were started laparoscopically, and only one of 20 had to be converted to open. Of these cases, 12 were for same-side recurrence and eight for a contralateral new hernia. With a follow-up of 28-74 months, there have been no fatalities, no complications, and no re-recurrence.
  
  
  CONCLUSIONS
  We have found that TEP repair of recurrent inguinal hernia after a primary TEP repair is entirely feasible technically as well as entirely safe.
authors.affiliation: Department of Surgery, Staten Island University Hospital, 65 Cromwell Avenue, Staten Island, NY 10304, USA. info@drferzli.com
authors.forename: G S
authors.initials: GS
authors.lastname: Ferzli
authors.forename: K
authors.initials: K
authors.lastname: Shapiro
authors.forename: S V
authors.initials: SV
authors.lastname: DeTurris
authors.forename: P
authors.initials: P
authors.lastname: Sayad
authors.forename: S
authors.initials: S
authors.lastname: Patel
authors.forename: A
authors.initials: A
authors.lastname: Graham
authors.forename: G
authors.initials: G
authors.lastname: Chaudry
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation / Q000009:adverse effects; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000601:surgery; D016896:Treatment Outcome