A comparison of patient recovery following unilateral and bilateral endoscopic preperitoneal herniorrhaphy

The advantage of using minimally invasive techniques over open techniques in the repair of inguinal hernias remains unclear. One of the more established indications for the performance of minimally invasive (e.g. endoscopic preperitoneal) herniorrhaphy is the presence of bilateral hernias. However, no prior study has compared the recovery following unilateral and bilateral endoscopic preperitoneal hernia repairs.

From July 15, 1994 through August 16, 1996 one primary surgeon performed 373 hernia repairs on 250 patients. Unilateral herniorrhaphy (UH) was performed on 114 males and 13 females with an average age of 58 (range 18-89). Bilateral herniorrhaphy (BH) was performed on 121 males and 2 females with an average age of 53 (range 18-86) (p > 0.05). Within the UH group there were 105 virgin hernias and 22 recurrent hernias. The BH group included 212 virgin hernias and 34 recurrent (p > 0.05). Bilateral repairs took longer to perform than unilateral repairs (65 minutes vs. 45 minutes) (p < 0.05). At the time of discharge, all patients were given a postoperative survey and asked to record their level of pain, narcotic use and level of activity on the day of surgery and postoperative days 1, 2, 3, 7, 14, and 28.

No differences were found in pain perception, narcotic use or level of activity on any of the days measured between the two groups (p > 0.05). In addition, both groups returned to work at a similar time (UH: 6.32 +/- 3.29 days, BH: 6.68 +/- 4.13 days) (p > 0.05).

Bilateral endoscopic preperitoneal herniorrhaphy can be performed with the same expected patient recovery as unilateral repairs.