总结腹腔镜腹股沟疝修补术（laparoscopic inguinal hernia repair，LIHR）后复发，应用腹腔镜经腹腹膜前疝修补术（laparoscopic trans-abdominal preperitoneal，TAPP）进行再次修补的临床经验。

回顾性分析2010年3月至2018年6月，广西医科大学第二附属医院收治的既往LIHR术后复发55例患者的临床资料，均行TAPP再次修补。术中在高位T型离断疝囊，旷置远端疝囊及既往补片，重新放置补片。

手术均顺利完成，无中转手术，平均手术时间（60.2±18.1）min，术后住院时间1～5 d，术后尿潴留3例（5.5%），腹股沟区血清肿3例（5.5%）；无肠道损伤、膀胱损伤，无补片感染；电话或信件随访4～28个月，无再次复发患者。

T型离断疝囊、旷置补片的TAPP术治疗既往LIHR术后复发的腹股沟疝患者是可行的，由于高位T型离断疝囊，避免剥离既往手术创面，旷置原补片，使得手术更为安全。

To summarize clinical experience of re-repair for recurrent hernia after laparoscopic inguinal hernia repair (LIHR) using laparoscopic transabdominal preperitoneal (TAPP) repair with the surgical method of replacing mesh by bypassing the previous mesh T-shaped transected hernia sac, and explore the safety and reliability of this method.

Fifty-five recurrent cases after laparoscopic preperitoneal repair for inguinal hernia in Second Affiliated Hospital of Guangxi Medical University from March 2010 to June 2018 were retrospectively analyzed. Intraoperatively, the distal hernia sac and the previous mesh were retained and the new mesh was replaced with the high T-shaped transected hernia sac.

All the surgery were successfully completed without converting to open surgery. The average surgical time was (60.2±18.1) minutes. The postoperative hospital stay was 1 to 5 daays. Postoperative urinary retention occurred in 3 (5.5%) cases and seroma in the inguinal region in 3 (5.5%) cases. No intestinal injury, bladder injury, or mesh infection occurred. Follow-up was performed by telephone or mail for 4 to 28 months, showing no recurrence.

It is feasible to treat recurrent inguinal hernia after LIHR by TAPP with T-shaped transected hernia sac and mesh exclusion. Because the high T-shaped hernia sac is transected, peeling off the previous surgical wound is avoided and the original mesh is retained, which makes the surgery safer.