Endoscopic totally extraperitoneal repair of bilateral inguinal hernias

Background: Recurrence rates associated with bilateral inguinal hernia repa ir with a giant prosthesis (Stoppa procedure) are low. Endoscopic totally e xtraperitoneal bilateral inguinal hernia repair which a giant prosthesis co mbines the low recurrence rate of the Stoppa repair and the advantages of m inimally invasive surgery. The aim of this retrospective study was to inves tigate whether extraperitoneal bilateral inguinal hernia repair could be pe rformed by the minimally invasive, totally estraperitoneal approach. Methods: From February 1993 to January 1998, 98 patients with bilateral ing uinal hernias underwent surgery. A polypropylene 30 x 10 cm rectangular mes h or a 30 x 10/15 cm 'slipmesh' was used. Follow-up, including a physical e xamination, of 96 per cent of patients was performed. Results: Median operative time was 60 min. Mostly minor intraoperative comp lications occurred. Conversion was required for two patients. Apart from on e patient with a necrotic fasciitis who died from respiratory failure, only minor postoperative complications (10 per cent) occurred. Median hospital sta) was 1 (range 1-21) days. Median recuperation time was 5 (range 1-22) d ays. Median follow-up (96 per cent) was 32 (range 7-57) months; there were six recurrences among 34 hernias in the group of 17 patients treated with 1 0 x 30 cm mesh and two (1 per cent) in the group that received 30 x 10/15 c m mesh (162 hernias in 81 patients). Conclusion: The endoscopic approach for the Stoppa procedure for bilateral inguinal hernia repair is a reliable method with minor complications. It en sures a short recuperation time and the recurrence rate is low owing to ade quate overlap of the hernial defect when a 'slipmesh' is used.