Of note, case 1 did not receive mesh removal whereas case 3 did. The difference between these two cases was that in case 3, the previously placed mesh was found to be shrunken and tightly adherent to the inferior selleck chemical epigastric artery. In addition to this, mesh migration was also seen and the mesh could be palpated from the skin externally. That is why the mesh had to be removed in this case. In case 1, however, the old mesh was just small and it was not removed since it did not complicate the relaparoscopic surgery. One major concern is the rerecurrence since the risk of recurring increases every time a hernia recurs and surgery is repeated. No recurrence after a mean followup of 17 months in this series is in accordance with the favourable results of earlier studies [5, 9, 11].

In their larger series with a longer follow-up period, van den Heuvel and Dwars [11] and Knook et al. [5] performed 49 and 18 TAPP repairs for recurrences after previous TAPP or TEP repairs, respectively, and encountered no rerecurrences. Similarly, Ferzli et al. [9] reported on 12 TEP repairs performed for the same-sided recurrence after primary TEP and there was also no rerecurrence in this series. Based on our experience with a small number of patients so far, relaparoscopic repair (either TAPP or TEP) appears to be a safe and effective procedure for the treatment of recurrent inguinal hernia, and repeated TEP could be a simpler approach than expected in the presence of no prior mesh fixation.
Adnexal masses are one of the most common indications for surgery in gynecology clinics, and laparoscopy is generally accepted as the gold standard treatment.

Classical laparoscopic surgery for adnexal masses is generally performed using ��3 trocars. On the other hand, single-port access surgery (SPAS), also known as laparoendoscopic single-site surgery (LESS) and single-incision laparoscopic surgery (SILS), is an evolving endoscopic approach for minimal access surgery. Various surgical procedures, including appendectomy, cholecystectomy, nephrectomy, oophorectomy, hysterectomy, adrenalectomy, gastric bypass, Nissen fundoplication, hernia repair, splenectomy, and colon resection, have been performed via SILS. SILS can result in better cosmesis, shorter recovery time, and less pain than conventional laparoscopy, which requires use of multiple trocar incisions [1, 2].

It was recently reported that adnexal masses could also be treated via SILS [3, 4]. Endoscopic surgery conducted via 3 special luminal ports, including the SILS port (Covidien, Norwalk, CT), GelPort (Applied Medical Resources, Rancho Santa Margarita, CA), and X-cone (Karl Storz, Tuttlingen, Dacomitinib Germany), as well as others, is frequently referred to as SILS. SILS requires a 2-3cm incision on the umbilicus for the placement of the special port.