Which technique is used in laparoscopic bilateral inguinal hernia surgery ?

INTRODUCTION: The present study aims to bridge this gap by providing an extensive comparative analysis of totally extraperitoneal (TEP) versus transabdominal preperitoneal (TAPP) techniques to correct bilateral inguinal hernias focussing on their efficiency, safety levels, and complications rates.
METHODS: We used a retrospective cohort study design that compared TEP with TAPP results among adult patients who underwent bilateral inguinal hernia repair from January 2021 to December 2023 at our institution. Exclusion criteria were recurrent hernias, emergency procedures, or patients who were not suitable for the minimally invasive approach. Surgical results, including complication rates, recovery outcomes, and operative details, were analysed in a systematic manner.
RESULTS: A total of 144 patients, 51 with TAPP and 93 with TEP, were included in the study. There was no statistical difference between the groups in terms of mean age, body mass index, length of hospital stay. The mean VAS scores in pain assessment the morning after surgery were 3.1 ± 1.5 (TAPP) and 2.9 ± 1.4 (TEP) respectively, and there was no significant difference between the two methods (p=0.346). Complications and readmission rates did not show significant differences between the two approaches.
DISCUSSION AND CONCLUSION: Both TEP and TAPP are effective laparoscopic methods that can be applied in bilateral inguinal hernia surgery. This is because no major complications are observed in either surgical procedure. Patient characteristics and surgical experience are the main determinants of the procedure to be chosen.