P-048 Does Bilateral Repair Increase Complication Rates Compared to Unilateral Repair in Patients Undergoing Laparoscopic Totally Extraperitoneal Inguinal Hernia Surgery?

Abstract

Introduction There is ongoing debate over whether to fix asymptomatic contralateral inguinal hernias during repair of the presenting hernia. This study reviewed the practice of one high-volume hernia surgeon, comparing unilateral and bilateral laparoscopic repairs, to establish if bilateral repair is associated with an increased risk of post-operative complications compared to unilateral repair. Material & Methods All patients operated on within a 5-year period were audited and subcategorised depending on whether they underwent unilateral or bilateral repair. Data was collected on complication rates, rates of recurrence, readmission within 30 days and duration of operation. Results 186 patients underwent repair of 265 hernias. 79 patients underwent bilateral repair. 25 patients suffered a complication (13.4%). Complication rates were 11.2% and 16.5% in the unilateral group and bilateral group respectively (p=0.50). These included superficial infection (1.9% vs 1.3%, p=0.75), haematoma (5.6% vs 7.6%, p=0.59), seroma (2.8 vs 7.6%, p=0.13), and chronic pain (0% vs 2.5%, p=0.01). There were no mesh infections, persisting numbness or explantation in either arm. In both groups, median nights stayed was 0. At median length of follow-up of 1.8 years, recurrence rates were 1.9% vs 0% in the unilateral and bilateral arms respectively (p=0.22). Conclusions There was no significant difference in rates of complications between the bilateral and unilateral arms. Opportunistic repair may reduce risk of future surgeries and morbidity and does not appear to be associated with increased complications. Surgeons may wish to consider this when consenting patients.

Comparative Analysis of Bilateral Open Inguinal Hernia Repair and Rives-Stoppa Repair: A Comprehensive Review

“…Complication rates vary between unilateral and bilateral inguinal hernia repairs. A comparative study between the two revealed complication rates of 11.2% for unilateral repairs and 16.5% for bilateral repairs, with no significant difference observed between the groups [ 32 ]. However, another investigation highlighted a higher incidence of postoperative complications within 30 days following bilateral repairs (4.9%) in contrast to unilateral repairs (3.9%), indicating a significantly greater risk associated with bilateral inguinal hernia repair [ 33 ].…”