A comparative outcome analysis of bilateral versus unilateral endoscopic extraperitoneal inguinal hernioplastics

Background: Bilateral inguinal hernia is an accepted indication for endoscopic totally extraperitoneal inguinal hernioplasty (TEP), but few studies have proved that the outcomes of bilateral TEP are as good as those of unilateral TEP. The objective of the present study was to compare the clinical outcomes of patients who underwent unilateral TEP with those of patients who underwent bilateral TEP. Patients and Methods: From June 1999 to May 2002, 103 patients underwent simultaneous bilateral TEP. The clinical data and outcomes of these patients were compared with those of an age-matched cohort of patients who underwent unilateral TEP during the same period. Results: The demographic features and hernia types were similar for the two groups. The incidence of direct inguinal hernia was significantly higher in the patients with bilateral inguinal hernia. The mean operative time for unilateral TEP was 65 minutes, and for bilateral TEP it was 97 minutes. The mean pain score at rest was significantly lower in the bilateral group than in the unilateral group on postoperative days 2 and 3. Pain scores at rest and during coughing from the day of operation to day 6 were otherwise comparable for the two groups. Comparisons of postoperative morbidity, length of hospital stay, and time to resumption of normal outdoor activities showed no significant differences between the two groups. Conclusions: The postoperative recovery and morbidity of patients who underwent bilateral TEP were equivalent to those who underwent unilateral TEP. Simultaneous bilateral TEP is safe and advantageous in patients with from bilateral inguinal hernias.