Abstract：
The Kugel procedure resulted in extensive adhesion in the preperitoneal space. Performing a transabdominal preperitoneal repair (TAPP) for recurrent hernia after Kugel procedure is extremely difficult. In this case report, we present the case of a 81-year-old male who presented with recurrent inguinal hernia after Kugel procedure 8 years ago. Transabdominal laparoscopy was performed first. Indirect hernia formed inferior to the lateral edge of the previous mesh was diagnosed under laparoscopy. The patient\'s medial umbilical ligament (MUL) was big enough and could be completely released by separating the Retzius space. Finally, TAPP was successfully performed by using the MUL to create and close the preperitoneal space. No perioperative complications or hernia recurrence was observed 1 year after the surgery. Using the MUL to deal with preperitoneal problems was practical and feasible.
摘要：
Kugel手术导致腹膜前间隙广泛粘连。Kugel手术后对复发性疝进行经腹腹膜前修复（TAPP）非常困难。在这个案例报告中,我们介绍了1例81岁男性,8年前Kugel手术后出现复发性腹股沟疝.首先进行了经腹腹腔镜检查。在腹腔镜检查下诊断出在先前网片的外侧边缘下方形成的间接疝。患者的脐内侧韧带（MUL）足够大，可以通过分离Retzius空间完全释放。最后,通过使用MUL创建并关闭腹膜前空间，成功执行了TAPP。术后1年无围手术期并发症及疝气复发。使用MUL处理腹膜前问题是切实可行的。
