Bilateral laparoscopic inguinal hernia repair in patients with occult contralateral inguinal defects

Bochkarev, Victor; Ringley, Chad D.; Vitamvas, Michelle; Oleynikov, Dmitry

doi:10.1007/s00464-007-9196-x

Cited by 54 publications

(46 citation statements)

References 12 publications

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“…The study also found that left-sided hernias were 10.5 times more likely to present with bilateral hernias than were right-sided hernias, whereas female sex, age less than 50 years, and right-sided hernia were less likely to have bilateral hernia [19]. A more recent study also showed 22% occurrence of bilateral defects in patients with unilateral inguinal hernia at TEP [20]. Another retrospective study has shown that, while the incidence of bilateral hernia in clinically unilateral hernias at TEP is 7.97%, only 1.12% of patients with unilateral hernia repair (who had undergone contralateral evaluation at surgery) subsequently developed a hernia on the other side over a 10-to 80-month follow-up period [21].…”

Section: Discussionmentioning

confidence: 87%

Is unilateral laparoscopic TEP inguinal hernia repair a job half done? The case for bilateral repair

et al. 2010

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In the present study bilateral TEP was performed in three types of patients: those with clinically bilateral hernias, those with clinically unilateral hernia but with an OCH, and in truly unilateral hernias. All of these were compared with unilateral TEPs in clinically unilateral hernias, and we found no significant increase in morbidity, pain, recurrence or complications in bilateral repairs. Convalescence from surgery, as determined by return to activities of daily living and return to work parameters, was also comparable. Surgeons experienced in laparoscopic TEP, in high-volume centers, can provide bilateral repairs in patients with inguinal hernia, bearing in mind its advantages and comparable morbidity. We also feel that, in elective repair of inguinal hernia, the patient should be given the option of bilateral repair. Bilateral repair does not add to the risk of surgery in experienced hands and we strongly feel that unilateral TEP is actually a job half done.

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Section: Discussionmentioning

confidence: 87%

Is unilateral laparoscopic TEP inguinal hernia repair a job half done? The case for bilateral repair

et al. 2010

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“…In contrast, with the TAPP approach, an expeditious and low-risk evaluation of the contralateral side can be carried out during diagnostic laparoscopy [24]. The high rate of discrepancy between preoperative clinical findings and the intraoperative existence of bilateral inguinal hernias found by Bochkarev et al [23] makes one question whether the preoperative diagnostics were done accurately. In summary, with TAPP an unnecessary exploration of the contralateral side can be avoided.…”

Section: Discussionmentioning

confidence: 95%

“…Similarly, in the total extraperitoneal patch plastic (TEP) technique, the indication for a bilateral procedure has to be found preoperatively [22] or additional preparation of the contralateral side has to be done to diagnose a potentially existing but preoperatively undiagnosed hernia. With this approach, Bochkarev et al [23] found an astonishing 22% of the patients with unknown hernias on the contralateral side. On the other hand, with bilateral preparation in the TEP technique, the preparation of the contralateral side is actually unnecessary in up to 78% of the patients, it takes time, and increases the risks.…”

Section: Discussionmentioning

confidence: 97%

Laparoscopic inguinal hernia repair: gold standard in bilateral hernia repair? Results of more than 2800 patients in comparison to literature

et al. 2010

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“…17 Despite some authors find confusion of the ideal definition of occult hernia and argue that it may be just patent process vaginalis (PPV) and not a true hernia which may be not in need for repair, however, in other studies mentioned that there is no clear difference in between occult hernia and (PPV) and the natural history is same in both entities with risk of future symptomatic hernia which advocates repair of occult hernias once it is encountered in same settings without concern about its size. 14,15,18 In this study, routinely repaired the (COH) if present and during preperitoneal space dissection we noticed that even in small occult hernias there were always a muscular hernia defect which is in fact in the side of concomitant repair of the (COH) repair if it is found intraoperative, with no reported intra or post-operative significant complications or extended hospital stay.…”

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confidence: 58%

The role of laparoscopic approach in bilaterality assessment in patients with unilateral inguinal hernia

2017

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Background: Patients presented with unilateral inguinal hernia are at risk for the possibility of contra-lateral occult hernias; small early-developed hernias may be difficult to be elicited by clinical, imaging assessment and during open repair. This study to evaluate laparoscopic identification of contra-lateral occult hernia with regard to the pre-operative clinical and imaging study.Methods: Retrospective analysis of patients presented in the period of March to December 2015 with unilateral inguinal hernia for which medical and ultrasound imaging assessment were done. Laparoscopic trans abdominal pre-peritoneal (TAPP) approach was done with intraoperative evaluation of the presence of contra-lateral occult hernias.Results: During the study period (27) patients (25 Males and 2 females) presented with unilateral inguinal hernia were clinically evaluated, 18 (66.6%) patients had right sided hernia, 9 (33.33%) had left sided, In all the studied patients routine ultrasound assessment was done and no documented cases of presence of contra-lateral hernia, Intraoperative abdominal exploration successfully Identifies bilateral inguinal hernias in 7 cases (25.9%) with mean age (44.14 years, SD 10.99) compared to (34.97 years, SD 10.51) in the Unilateral group, 3 cases on the left side (16.6% of total right side patients) and 4 cases on the right side (44.4% of total left side patients). operative time for unilateral repair was (Mean 85.8 minutes, SD 18.8), and for discovered bilateral cases (Mean 145.9 minutes, SD 46.8).Conclusions: The presence of occult inguinal hernia is a frequent finding specially in older age group of patients, also in our study we found the percentage of occult hernias are more in patients presented with left side disease. Laparoscopic (TAPP) approach is a useful tool for assessment of the presence of such hernias, and gives the privilege of simultaneous repair in same operation with the advantage of avoiding the patient’s later surgery together with the laparoscopic surgery benefits of less pain, rapid recovery and shorter hospital stay.

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Bilateral laparoscopic inguinal hernia repair in patients with occult contralateral inguinal defects

Cited by 54 publications

References 12 publications

Is unilateral laparoscopic TEP inguinal hernia repair a job half done? The case for bilateral repair

Is unilateral laparoscopic TEP inguinal hernia repair a job half done? The case for bilateral repair

Laparoscopic inguinal hernia repair: gold standard in bilateral hernia repair? Results of more than 2800 patients in comparison to literature

The role of laparoscopic approach in bilaterality assessment in patients with unilateral inguinal hernia

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