Background: The most effective method of repair of inguinal hernia is by 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 one-setting laparoscopic transabdominal preperitoneal patch
(TAP!',) repair of bilateral inguinal hernia in comparison to the standard Stoppa technique. Method. The
study included 40 male patients with mean age of 47.4±8.8 years. Patients were randomly divided into two
groups: Open group undo went Standard Stoppa procedure and laparoscopic group assigned to
laparoscopic TAP!' repair. Operative time, frequency of intraoperative and postoperative complications,
time till resumption of oral intake, time for mobilization, and postoperative hospital stay v'ere 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 1.4 PP 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 !Ole.
Keywords: laparoscopic trans-abdominal pre-peritoneal, Stoppa technique, bilateral inguinal hernia |
