Is Prophylactic Laparoscopic Total Extraperitoneal Inguinal Hernia Repair on Contralateral Side Justified: A Comparative Study of Bilateral to Unilateral Repair in 1754 Hernias

Objective- To study the outcome and morbidity parameters of total extraperitoneal (TEP) repair in patients with recurrent inguinal hernia and assess as how they are different from the primary inguinal hernia repair.

Patients & Methods- A retrospective analysis was carried out over a three-year period in 937 patients in whom TEP was done. The recurrence rate, pain scores at 24 hours, 1 week and 4 weeks, hospital stay, days to resume normal activities, seroma formation and urinary retention rates were noted. Pain scoring was done as -1=no pain, 2=mild pain, 3=moderate pain, 4=severe pain and 5=intolerable pain. The mean pain scores were calculated.

Results-In 937 patients, 52 patients underwent recurrent and 885 patients underwent primary hernia repair. Mean age was 48.4 ±14.5 yrs and 46.1±14.2 yrs in the recurrent and primary groups respectively (p=0.2, NS, t-test). Follow up range was 12-40 months (median- 25 months). The mean operating time was more in the recurrent group (32.7 ± 6.3 minutes) compared to the primary group (30.1 ± 6.1 minutes)(p=0.015, t-test). The mean pain scores at 24 hours were similar in both the groups (2.28±0.5-recurrent vs. 2.20 ± 0.4 – primary group, p=NS, t-test). However the pain scores at one week were significantly higher in the recurrent group (1.35 ±0.5) than the primary group (1.20 ±0.4) (p=0.017, t-test). The hospital stay and the days taken to resume normal activities were significantly longer in the recurrent than the primary group. (Hospital stay- 1.19 ±0.4 vs. 1.07 ±0.3 days, p= 0.002; Resume normal activities- 8.62 ± 2.6 vs. 7.67 ± 1.4 days, p

Session: Poster

Program Number: P453

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