We have performed laparoscopy-assisted inguinal hernioplasty via the anterior approach, observing the state of the hernia laparoscopically, for 2 cases of recurrent inguinal hernia after mesh plug repair. In both cases, the hernia was repaired by inserting another mesh plug into the hernia orifice without removing the placed onlay mesh and plug. The patients have been doing well and there have been no signs of recurrence.
Open mesh plug hernioplasty under local anesthesia is adapted as our standard technique for inguinal hernia in adult patients. But for recurrent inguinal hernia after mesh plug repair, laparoscopy-assisted surgery allows easy and accurate recognition of the hernia sac and it is possible to perform a repair with a minimally invasive approach by inserting another mesh plug into the hernia orifice without performing unnecessary adhesiolysis in the inguinal canal. The laparoscopy-assisted anterior approach is a simple and reliable method for recurrent inguinal hernia after mesh plug repair, and thus from now on, this will be our method of choice.