An analysis of the results of repeated operations performed on 152 patients for recurrent inguinal hernias for the period from January 2010 to December 2020 at the Odesa Regional Clinical Hospital was conducted. In 34 (22.4 %) cases, recurrences of inguinal hernia occurred after autoplasty, 82 (53.9 %) - after Lichtenstein hernioplasty, in 36 (23.7 %) cases, recurrence of PG occurred after laparoscopic hernioplasty. The sample was dominated by men (144 or 94.7 %). At the preoperative stage, all patients were carefully examined according to current clinical protocols, and in addition, they underwent ultrasound of the inguinal canal. 11 (9.1 %) patients underwent CT of the pelvic organs, another 2 (1.7 %) patients underwent MRI of the pelvic organs. Data from these studies also confirmed the presence of recurrence of inguinal hernias. The choice of the method of intervention was determined by randomization, with the help of which each clinical group was divided into subgroups, in one of which Lichtenstein surgery was performed, and in the other - laparoscopic intervention in the volume of TAPP. Further analysis showed complete comparability of clinical and anamnestic characteristics in the formed clinical subgroups, which testifies to the correctness of the randomization procedure. In the early postoperative period, all complications were taken into account and recorded, especially the severity of the pain syndrome, the presence of an inflammatory reaction of the tissues and impaired diuresis. The period of observation of patients was from 12 to 24 months. In the long term, the patients underwent a thorough clinical and instrumental examination to diagnose a possible recurrence of the hernia. Group I included 34 patients in whom repeating hernioplasty occurred after previous autohernioplasty. Than, either the laparoscopic method in the volume of TAPP (n=14) - IA group, or Lichtenstein's hernioplasty (n=20) - IV group was chosen for re-intervention. Group II included 82 patients who had previously undergone hernioplasty according to Lichtenstein. They were randomly assigned to subgroups IIA (n=40, TAPP) and IIB (n=42, HPL). Group III includes (n=36) patients who underwent laparoscopic TAPP intervention. They were assigned to subgroups IIIA (n=17, TAPP) and IIIB (n=19, HPL). In addition to hernioplasty, 44 (28.9 %) patients had a history of other surgical procedures, including 19 (12.5 %) appendectomies, 13 (8.6 %) cholecystectomies, 8 (5.3 %) endoscopic interventions for choledocholithiasis, 3 (1.9 %) - cesarean sections and 1 (0.6 %) - intervention for ectopic pregnancy, 1 (0.5 %) - revision of abdominal organs due to penetrating wound, 1 ( 0.5 %) - neurosurgical intervention for arteriovenous malformation. The average BMI was (27.7±1.2) kg/m2. According to the anamnesis data, 29 (24.0 %) patients with RIH developed infectious complications, including 1 edostatic size of the WS=2.8 (CI95 % 1.6; 3.9), insufficient fixation of the lower medial edge of the grid (WS=2.5 (CI95 % 1.5#3.5), as well as factors related to general somatic the condition of the patient (hypertrophic or hypotrophic nutritional status, manifestations of connective tissue dysplasia syndrome) Chronic pain syndrome is the most frequent complication after reconstructive interventions for RIH (up to 25 % of cases). The incidence of chronic pain was higher after repeated open interventions. An improved method of laparoscopic hernioplasty for RIH has been developed, which allows to reduce the frequency of recurrence, due to the selection of light meshes reinforced with titanium oxide, the size of which is not less than 12x15 cm, and the fixation of their lower-medial edge with nodal sutures to the inguinal ligament. If it is impossible to remove the previously installed alloprosthesis, a new mesh is installed on top of the previous one. Laparoscopic interventions are the method of choice for RIH, but require an expert level of the operator. If necessary, conversion to open intervention under Liechtenstein is permissible.
