Is a dissection balloon beneficial in bilateral, totally extraperitoneal, endoscopic hernioplasty? A randomized, prospective, multicenter study

Laparoscopic hernioplasty has been criticized because of its technical comp lexity and increased costs. Disposable dissection balloons can be used to g ain the initial working space in totally extraperitoneal endoscopic (TEP) h ernioplasty, but this increases its cost. Forty-four men with bilateral, pr imary or recurrent inguinal hernias were randomized to undergo TEP with or without dissection balloon, There were two conversions to transabdominal pr eperitoneal hernioplasty, or open herniorrhaphy, in the group with balloon and four in the group without balloon. There was no difference in the posto perative morbidity or operation time between the two groups, and there were no major complications in either group. The recurrence rate was 4.3% in th e group with the balloon and 7.1% in the group without the balloon. There w ere no statistically significant differences between the groups, Although o ur study population is too small to detect small differences between the gr oups, it seems that the use of a dissection balloon is not beneficial in a bilateral TEP.