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Objectives: Inguinal hernia recurrence after surgical repair is still a rather common occurrence in large published series. Current data indicates rate of recurrence ranging 0.2-10%. The optimal approach for repair of a recurrent inguinal hernia is still in question.
We sought to query the NSQIP database to ascertain the national trends in the approach to recurrent non-obstructed inguinal hernias.
Methods: The NSQIP database was queried for laparoscopic or open recurrent inguinal hernia repair from 2007 to 2009. Age, gender and comorbidities were quantified and outcomes data collected. Specifically, morbidity, mortality, length of stay and operative times were examined. Statistical analysis was then performed. A p-value of < 0.05 was considered significant.
Results: A total of 3874 patients were identified who were diagnosed with recurrence of inguinal hernia, out of which 2692 underwent open hernia repair, while 1182 underwent laparoscopic repair.
Conclusion: It appears that 30% of recurrent inguinal hernias were repaired laparoscopically. Both laparoscopic and open approaches to repair of recurrent inguinal non-obstructed hernias have comparable profile of patient population, safety and complications. The final choice of surgical approach should be made based on the surgeon's preference.

	Open Repair N=2692	Laparoscopic Repair N=1182	P-Value
Age	60.4 ± 15.7	57.1 ± 14.9	<.001
Male gender	2539 (94.3%)	1117 (94.5%)	0.880
Diabetes on Insulin	40 (1.5%)	10 (0.8%)	0.020
HTN	1111 (41.3%)	390 (33%)	<.001
COPD	97 (3.6%)	21 (1.8%)	.002
CHF in 30 days	6 (0.2%)	0	0.187
History of MI in 6months	4 (0.1%)	1 (0.1%)	1
Prior PCI	182 (6.8%)	49 (4.1%)	0.001
Prior CABG	208 (7.7%)	54 (4.6%)	<.001
PAD	23 (0.9%)	5 (0.4%)	0.215
ESRD	20 (0.7%)	2 (0.2%)	.034
Smoker	502 (18.6%)	206 (17.4%)	0.391
Steroid use	42 (1.6%)	14 (1.2%)	0.465
Partially Dependent	28 (1.0%)	2 (0.2%)	0.015
Totally Dependent	4 (0.1%)	1 (0.1%)	0.015
BMI	26.2 ± 4.2	26.4 ± 4.3	0.309
ASA III or above	46 (1.7%)	12 (1.0%)	0.114

	Open Repair N=2692	Laparoscopic Repair N=1182	P-Value
Superficial SSI	9 (0.3%)	5 (0.4%)	0.772
Deep incisional SSI	2 (0.1%)	1 (0.1%)	1
Pneumonia	2 (0.1%)	1 (0.1%)	1
Return to OR	24 (0.9%)	8 (0.7%)	0.568
UTI	9 (0.3%)	8 (0.7%)	0.184
MI	1 (0%)	0	1
DVT	7 (0.3%)	0	0.214
Operative time (min)	65.7 ± 34	72 ±36	<0.001
Length of stay (days)	0.25 ± 0.91	0.30 ± 1.6	0.281