Background: The most effective method of repair of inguinal hernia is by means of a
tension-free technique involving the use of prosthetic mesh to reinforce the abdominal wall in
the region of the groin. This can be accomplished by open or laparoscopic techniques. The
aim of this prospective comparative study is to evaluate the feasibility and outcome of onesetting
laparoscopic transabdominal preperitoneal patch (TAPP) repair of bilateral inguinal
hernia in comparison to the standard Stoppa technique.
Methods: The study included 40 male patients with mean age of 47.4±8.8 years. Patients
were randomly divided into two groups: Open group underwent Standard Stoppa procedure
and laparoscopic group assigned to laparoscopic TAPP repair. Operative time, frequency of
intraoperative and postoperative complications, time till resumption of oral intake, time for
mobilization, and postoperative hospital stay were recorded. Postoperative pain was evaluated
using 4-grade verbal pain analogue scale and patients' satisfaction was graded at end of
follow-up.
Results: Laparoscopic TAPP provided superior operative and immediate postoperative
outcome manifested as significantly shorter operative time, time till first mobilization, till
resumption of oral intake and shorter duration of hospital stay. Postoperative pain data
showed significantly lower pain scores with significantly lower total score and fewer numbers
of requests of rescue analgesia in laparoscopic group compared to open group. Five patients
developed seroma at the hernia site; 3 in laparoscopic and 2 in open group and 3 patients in
open group developed postoperative wound infection, while only one patient in laparoscopic
group had port site infection. No recurrence was reported in both groups throughout a mean
duration of follow-up of 17.5±4.1; range: 12-25 months. Mean satisfaction rate was
significantly higher in laparoscopic group compared to open group.
Conclusion: One-setting laparoscopic TAPP for bilateral inguinal hernia is feasible, safe ,
offers an effective and elegant alternative to the standard Stoppa technique with superior
immediate postoperative outcome and higher patients' satisfaction rate. |
