Abstract
Background/Objectives: Recurrent groin and ventral hernias remain technically challenging, and the optimal operative approach is not uniform. This study compared postoperative outcomes after open and minimally invasive repair and examined recurrent inguinal hernia subgroups. Methods: This retrospective single-center cohort included 87 adults undergoing elective repair between September 2017 and May 2026; 45 underwent open repair and 42 underwent minimally invasive repair. The primary endpoint was 30-day postoperative morbidity; secondary endpoints were postoperative pain requiring medical evaluation, re-recurrence, and length of hospital stay. Subgroup analyses included 60 patients with recurrent inguinal hernia; within this subgroup, a technique-specific analysis included 48 patients treated with Lichtenstein (n = 24) or TAPP/TEP (n = 24) repair. Results: Thirty-day complications occurred in 22.2% after open and 16.7% after minimally invasive repair (p = 0.514). Postoperative pain occurred in 20.0% and 9.5% (p = 0.171), and re-recurrence in 4.4% and 7.1% (p = 0.669), respectively. Median hospital stay was 1 day in both groups. In recurrent inguinal hernias, pain was more frequent after open than laparo-endoscopic repair (22.2% vs. 0%; p = 0.017) and after Lichtenstein versus TAPP/TEP repair (25.0% vs. 0%; p = 0.022). Conclusions: Open and minimally invasive repair showed comparable short-term outcomes in the overall cohort, although these findings should be interpreted in the context of the anatomical and technical differences between recurrent groin and ventral hernias. In the more homogeneous recurrent inguinal subgroup, the lower frequency of clinically documented pain after laparo-endoscopic repair warrants prospective confirmation with standardized pain assessment.