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(a) Recurrent hernia orifice was confirmed inferior to the lower edge of the mesh (white arrow). (b) Close-up view of the hernia.
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To diagnose the type of recurrence and clarify the location of the defect, the orifice was inspected using laparoscopy and a 2-cm indirect hernia was detected inferior to the lower edge of the mesh (Fig. 1a and b).
The plug (arrow head) appropriately covers the inguinal floor with the previous mesh through the observation of the abdominal cavity under laparoscopy.
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Franklin Lakes, NJ, USA) plug (height 3.8 cm, diameter 5.1 cm) was fixed to the transverse fascia and the previous mesh with six interrupted stitches using absorbable sutures. Finally, the overlap was confirmed to sufficiently cover the myopectineal orifice, and the plug was inverted under the peritoneal membrane using laparoscopy with increased pneumoperitoneum (Fig. 2).