Autoplasty combined with autodermoplasty in the treatment of recurrent inguinal hernia

Introduction. The results of treatment of inguinal hernias are unsatisfactory. 13% of all hernia repairs in the world are performed due to recurrent inguinal hernia (RIH). Most often, relapses occur after autoplastic surgery (29-30%). Modern alloplastic methods of hernia repair, open or closed, are not devoid of relapses. Even after total preperitoneal alloplasty, they reach 10-15%. In addition, the disadvantage of these operations is their high cost.Materials and methods. Retrospective analysis of case histories of 99 patients with RIH operated on in 1999-2020 in whom were used autoplasty methods with autodermoplasty was performed: 1. Preperitoneal autodermoplasty of the posterior wall of inguinal canal with autoplasty of the anterior wall; 2. Posterior wall autoplasty of the inguinal canal using a relaxing incision of the anterior wall of the sheath of rectus muscle with autodermoplasty.Results. There were 6 (6,1%) complications in the early postoperative period and 7 (7%) cases of recurrences in the long term.Conclusion. Preperitoneal autodermoplasty with autoplasty of the anterior wall of the inguinal canal insufficiently protects the inguinal region from the recurrence: 5 (12,5%) hernia recurrences were revealed among the operated 40 patients in the long term. Autoplasty of the posterior wall of inguinal canal with relaxing incisions of the aponeurosis of the anterior leaf of sheath of rectus muscle with autodermoplasty according to proposed methods was the most reliable. No recurrences were found among the 40 operated patients (follow-up of 12 years).