Midline single-port eTEP stoppa repair for bilateral inguinal hernia: How I do it.

Area of Science:

• Minimally Invasive Surgery
• Hernia Repair
• Surgical Innovation

Background:

• Bilateral inguinal hernias often require complex repair techniques.
• Conventional methods may involve crossover manipulation, potentially increasing operative difficulty.
• A wide, continuous working cavity is desirable for optimal surgical outcomes.

Purpose of the Study:

• To evaluate the feasibility and outcomes of a midline single-port enhanced totally extraperitoneal (eTEP) Stoppa repair for primary bilateral inguinal hernias.
• To assess the safety and efficacy of creating early bilateral extraperitoneal continuity.
• To explore potential ergonomic advantages compared to conventional techniques.

Main Methods:

• Retrospective case series of patients undergoing midline single-port eTEP Stoppa repair (January 2020 - December 2025).
• Inclusion criteria: primary bilateral inguinal hernias; exclusion criteria: recurrent, incarcerated, or large scrotal hernias.
• Analysis of operative outcomes, complications (Clavien-Dindo), and follow-up data.

Main Results:

• Forty-four patients completed the procedure with no conversions.
• Median operative time was 121 minutes; median length of stay was 2 days.
• No Clavien-Dindo grade ≥ II complications, recurrences, or incisional hernias were observed during a median follow-up of 565 days.

Conclusions:

• Midline single-port eTEP Stoppa repair effectively creates early bilateral extraperitoneal continuity.
• This technique provides a wide operative field and eliminates crossover manipulation.
• It presents a distinct and potentially advantageous alternative to conventional bilateral totally extraperitoneal (TEP) repair.