Bilateral inguinal hernias repair: Analytic study of 71 patients

A retrospective review of a series of 71 patients operated on between January 1986 and December 1995, for bilateral inguinal hernias was carried out. The patients were treated by insertion of a non-absorbable unslit mesh via either the inguinal route or a laparoscopic approach. A two stage operation via the inguinal route was performed in 23 patients (group A). The remainder underwent a one-stage procedure: 23 patients (group B) were offered open repair using a preperitoneal mesh via a bilateral inguinal route and 25 patients (group C) underwent bilateral laparoscopic repair through a totally preperitoneal approach (n=is) or a transperitoneal approach (n=10). The three groups were broadly similar and comparable. The length of operative procedure was identical in the 3 groups. The duration of hospital stay was respectively 11.2, 5.8 and 3.3 days in the three groups. The return to normal activities was shorter in groups B and C than in group A. At long term, with a mean follow-up of two years, the rate of recurrence was similar in the 3 groups. This study confirmed that a one stage operation does not carry great risks, and has the advantages of sparing the patient a second operation. It is economical in terms of operating time, duration of hospital stay, and delay in return to work. The laparoscopic procedure seems the most suitable approach for these hernia repairs. Further investigation of this technique in comparison with other open herniorrhaphy procedures, with randomised prospective trials, is required before its widescale application can be recommended.