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Preperitoneal bilateral inguinal herniorrhaphy evolution of a technique from conventional to laparoscopic
J M Velasco1, C Gelman, V L Vallina
1Department of Surgery, Rush University and Rush North Shore Medical Center, Skokie, IL 60076, USA.
Background:
Simultaneous repair of bilateral inguinal hernia remains controversial.
Methods:
Seventy-two consecutive patients underwent a preperitoneal prosthetic repair of bilateral groin hernia; 25 via laparoscopy. ASA classification, Nyhus type, hospitalization, convalescence time, and cost were examined. Mean follow-up was 36 and 12 months for the conventional and laparoscopic group respectively.
Results:
Sixty-nine patients were available for long-term follow-up. Average hospital stay, recurrence rate, perioperative urinary retention, transient thigh neuralgia, and return to normal activities were 48 hours, 5%, 9%, 6%, and 22 days as compared to 4 hours, 6%, 20%, 12%, and 9 days for the conventional and laparoscopic group respectively. The cost for laparoscopic repair was $500 greater.
Conclusions:
The preperitoneal approach to repair of bilateral hernias demonstrates an acceptable recurrence rate with low long-term morbidity. Experience with conventional preperitoneal technique greatly facilitates transition to laparoscopic repair.