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Related Experiment Videos

Simultaneous bilateral hernia repair. A case against conventional wisdom.

A R Miller1, J A van Heerden, J M Naessens

  • 1Section of Gastroenterologic and General Surgery, Mayo Clinic, Rochester, Minnesota 55905.

Annals of Surgery
|March 1, 1991
PubMed
Summary

Simultaneous bilateral inguinal hernia repair shows similar recurrence rates to unilateral repair. While bilateral procedures had more overall morbidity, specific complication rates were comparable, except for increased urinary retention.

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Area of Science:

  • Surgical outcomes research
  • Hernia surgery
  • Comparative effectiveness

Background:

  • The optimal timing for bilateral inguinal hernia repair is debated.
  • Concerns exist regarding high recurrence rates with simultaneous bilateral repair, leading to suggestions for staged procedures.

Purpose of the Study:

  • To compare recurrence and complication rates between unilateral and simultaneous bilateral inguinal hernia repair.
  • To provide evidence-based guidance on surgical timing for bilateral inguinal hernias.

Main Methods:

  • Retrospective analysis of 659 patients undergoing hernia repair between 1974 and 1980.
  • Patients were divided into unilateral (333) and simultaneous bilateral (329) repair groups.
  • Long-term follow-up (median 104 months) to assess recurrence and complication rates.

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Main Results:

  • Overall perioperative complications occurred in 18% of repairs, with higher morbidity in the bilateral group.
  • Urinary retention was significantly higher in the bilateral group (15%) compared to the unilateral group (6.1%).
  • No significant differences in overall recurrence rates were observed between unilateral and simultaneous bilateral repair at 5 and 9 years.

Conclusions:

  • Simultaneous bilateral inguinal herniorrhaphy does not lead to increased rates of most postoperative complications or recurrence compared to unilateral repair.
  • Staged procedures may not be necessary solely due to concerns about recurrence in bilateral inguinal hernia repair.