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Laparoscopic inguinal hernia repair: gold standard in bilateral hernia repair? Results of more than 2800 patients in comparison to literature

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Abstract

Background

Advantages and disadvantages of open and endoscopic hernia surgery are still being discussed. Until now there has been no study that evaluated the advantages and disadvantages of bilateral hernia repair in a large number of patients.

Methods

Our prospectively collected database was analyzed to compare the results of laparoscopic bilateral with laparoscopic unilateral hernia repair. We then compared these results with the results of a literature review regarding open and laparoscopic bilateral hernia repair.

Results

From April 1993 to December 2007 there were 7240 patients with unilateral primary hernia (PH) and 2880 patients with bilateral hernia (5760 hernias) who underwent laparoscopic transabdominal preperitoneal patch plastic (TAPP). Of the 10,120 patients, 28.5% had bilateral hernias. Adjusted for the number of patients operated on, the mean duration of surgery for unilateral hernia repair was shorter than that for bilateral repair (45 vs. 70 min), but period of disability (14 vs. 14 days) was the same. Adjusted for the number of hernias repaired, morbidity (1.9 vs. 1.4%), reoperation (0.5 vs. 0.43%), and recurrence rate (0.63 vs. 0.42%) were similar for unilateral versus bilateral repair, respectively. The review of the literature shows a significantly shorter time out of work after laparoscopic bilateral repair than after the bilateral open approach.

Conclusions

Simultaneous laparoscopic repair of bilateral inguinal hernias does not increase the risk for the patient and has an equal length of down time compared with unilateral repair. According to literature, recovery after laparoscopic repair is faster than after open simultaneous repair. Laparoscopic/endoscopic inguinal hernia repair of bilateral hernias should be recommended as the gold standard.

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References

  1. Fitzgibbons RJ Jr, Camps J, Cornet DA, Nguyen NX, Litke BS, Annibali R, Salerno GM (1995) Laparoscopic inguinal herniorrhaphy. Results of a multicenter trial. Ann Surg 221:3–13

    Article  PubMed  Google Scholar 

  2. Rutkow IM (1990) The socioeconomic aspects of surgical therapy. A viewpoint from the USA. Chirurg 61:874–879

    CAS  PubMed  Google Scholar 

  3. Junge K, Rosch R, Klinge U, Schwab R, Peiper C, Binnebosel M, Schenten F, Schumpelick V (2006) Risk factors related to recurrence in inguinal hernia repair: a retrospective analysis. Hernia 10:309–315

    Article  CAS  PubMed  Google Scholar 

  4. Reuben B, Neumayer L (2006) Surgical management of inguinal hernia. Adv Surg 40:299–317

    Article  PubMed  Google Scholar 

  5. Camps J, Nguyen N, Annabali R, Fitzgibbons RJ Jr (1995) Laparoscopic inguinal herniorrhaphy: transabdominal techniques. Int Surg 80:18–25

    CAS  PubMed  Google Scholar 

  6. Wishart GC, Wright D, O’Dwyer PJ (1995) Use of a Foley catheter to dissect the preperitoneal space for extraperitoneal endoscopic hernia repair. J Laparoendosc Surg 5:27–29

    CAS  PubMed  Google Scholar 

  7. Sosa JL, Puente I, Markley M, Tranakas N (1994) A modified technique of laparoscopic herniorrhaphy: operative approach and early results. Int Surg 79:300–303

    CAS  PubMed  Google Scholar 

  8. Dulucq JL (1992) Treatment of inguinal hernia by insertion of a subperitoneal patch under pre-peritoneoscopy. Chirurgie 118:83–85

    CAS  PubMed  Google Scholar 

  9. Arregui ME, Davis CJ, Yucel O, Nagan RF (1992) Laparoscopic mesh repair of inguinal hernia using a preperitoneal approach: a preliminary report. Surg Laparosc Endosc 2:53–58

    CAS  PubMed  Google Scholar 

  10. McKernan JB, Laws HL (1993) Laparoscopic repair of inguinal hernias using a totally extraperitoneal prosthetic approach. Surg Endosc 7:26–28

    Article  CAS  PubMed  Google Scholar 

  11. Leibl BJ, Jager C, Kraft B, Kraft K, Schwarz J, Ulrich M, Bittner R (2005) Laparoscopic hernia repair—TAPP or/and TEP? Langenbecks Arch Surg 390:77–82

    Article  CAS  PubMed  Google Scholar 

  12. Krahenbuhl L, Schafer M, Buchler MW (1997) Laparoscopic transperitoneal inguinal hernia operation (TAPP). Chirurg 68:977–985

    Article  CAS  PubMed  Google Scholar 

  13. Schmedt CG, Daubler P, Leibl BJ, Kraft K, Bittner R (2002) Simultaneous bilateral laparoscopic inguinal hernia repair: an analysis of 1336 consecutive cases at a single center. Surg Endosc 16:240–244

    Article  PubMed  Google Scholar 

  14. Bittner R, Leibl BJ, Ulrich M (2006) Chirurgie der Leistenhernie. Minimalinvasive Operationstechniken. Karger, Basel

    Google Scholar 

  15. Bittner R, Schmedt CG, Leibl BJ (2003) Transabdominal pre-peritoneal approach. In: Le Blanc K (ed) Laparoscopic hernia surgery: an operative guide, 1st edn. Arnold, London

    Google Scholar 

  16. Gainant A, Geballa R, Bouvier S, Cubertafond P, Mathonnet M (2000) Prosthetic treatment of bilateral inguinal hernias via laparoscopic approach or Stoppa procedure. Ann Chir 125:560–565

    Article  CAS  PubMed  Google Scholar 

  17. Krahenbuhl L, Schafer M, Schilling M, Kuzinkovas V, Buchler MW (1998) Simultaneous repair of bilateral groin hernias: open or laparoscopic approach? Surg Laparosc Endosc 8:313–318

    Article  CAS  PubMed  Google Scholar 

  18. Mahon D, Decadt B, Rhodes M (2003) Prospective randomized trial of laparoscopic (transabdominal preperitoneal) vs open (mesh) repair for bilateral and recurrent inguinal hernia. Surg Endosc 17:1386–1390

    Article  CAS  PubMed  Google Scholar 

  19. Sarli L, Iusco DR, Sansebastiano G, Costi R (2001) Simultaneous repair of bilateral inguinal hernias: a prospective, randomized study of open, tension-free versus laparoscopic approach. Surg Laparosc Endosc Percutan Tech 11:262–267

    Article  CAS  PubMed  Google Scholar 

  20. Velasco JM, Gelman C, Vallina VL (1996) Preperitoneal bilateral inguinal herniorrhaphy evolution of a technique from conventional to laparoscopic. Surg Endosc 10:122–127

    CAS  PubMed  Google Scholar 

  21. Kraft BM, Kolb H, Kuckuk B, Haaga S, Leibl BJ, Kraft K, Bittner R (2003) Diagnosis and classification of inguinal hernias. Surg Endosc 17:2021–2024

    Article  CAS  PubMed  Google Scholar 

  22. Schug-Paß C, Wunder R, Tamme C, Köckerling F (2006) Die bilaterale Leistenhernie, eine Indikation für die endoskopisch extraperitoneale Versorgung (TEP)—Ergebnisse eine prospektiven Studie. Deutsche Gesellschaft für Chirurgie. 123. Kongress der Deutschen Gesellschaft für Chirurgie, Berlin, 2-5 May 2006. Düsseldorf, Köln: German Medical Science, Doc 06dgch4738

  23. Bochkarev V, Ringley C, Vitamvas M, Oleynikov D (2007) Bilateral laparoscopic inguinal hernia repair in patients with occult contralateral inguinal defects. Surg Endosc 21:734–736

    Article  CAS  PubMed  Google Scholar 

  24. Sarli L, Pietra N, Choua O, Costi R, Thenasseril B, Giunta A (1997) Prospective randomized comparative study of laparoscopic hernioplasty and Lichtenstein tension-free hernioplasty. Acta Biomed Ateneo Parmense 68:5–10

    CAS  PubMed  Google Scholar 

  25. Novitsky YW, Czerniach DR, Kercher KW, Kaban GK, Gallagher KA, Kelly JJ, Heniford BT, Litwin DE (2007) Advantages of laparoscopic transabdominal preperitoneal herniorrhaphy in the evaluation and management of inguinal hernias. Am J Surg 193:466–470

    Article  PubMed  Google Scholar 

  26. Saggar VR, Sarangi R (2007) Occult hernias and bilateral endoscopic total extraperitoneal inguinal hernia repair: is there a need for prophylactic repair? Results of endoscopic extraperitoneal repair over a period of 10 years. Hernia 11:47–49

    Article  CAS  PubMed  Google Scholar 

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Disclosures

Constantin Aurel Wauschkuhn, Jochen Schwarz, Ulf Boekeler, and Reinhard Bittner have no conflicts of interest or financial ties to disclose.

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Wauschkuhn, C.A., Schwarz, J., Boekeler, U. et al. Laparoscopic inguinal hernia repair: gold standard in bilateral hernia repair? Results of more than 2800 patients in comparison to literature. Surg Endosc 24, 3026–3030 (2010). https://doi.org/10.1007/s00464-010-1079-x

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  • DOI: https://doi.org/10.1007/s00464-010-1079-x

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