PREPERITONEAL BILATERAL INGUINAL HERNIORRHAPHY - EVOLUTION OF A TECHNIQUE FROM CONVENTIONAL TO LAPAROSCOPIC

Background: Simultaneous repair of bilateral inguinal hernia remains c ontroversial. Methods: Seventy-two consecutive patients underwent a pr eperitoneal prosthetic repair of bilateral groin hernia; 25 via laparo scopy. ASA classification, Nyhus type, hospitalization, convalescence time, and cost were examined. Mean follow-up was 36 and 12 months for the conventional and laparoscopic group respectively. Results: Sixty-n ine patients were available for longterm follow-up. Average hospital s tay, recurrence rate, perioperative urinary retention, transient thigh neuralgia, and return to normal activities were 48 hours, 5%, 9%, 6%, and 22 days as compared to 4 hours, 6%, 20%, 12%, and 9 days for the conventional and laparoscopic group respectively. The cost for laparos copic repair was $500 greater. Conclusions: The preperitoneal approach to repair of bilateral hernias demonstrates an acceptable recurrence rate with low long-term morbidity. Experience with conventional preper itoneal technique greatly facilitates transition to laparoscopic repai r.