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The best approach for simultaneous repair of bilateral inguinal hernia is controversial. The aim of this study is to compare the outcomes after laparoscopic versus open mesh repair of bilateral primary inguinal hernia
This prospective study included 180 patients with bilateral primary inguinal hernia; randomized by sealed envelopes into 3 groups; each includes 60 patients. Group I treated by laparoscopic trans-abdominal pre-peritoneal (TAPP) repair using 2 separate meshes, Group II treated by open pre-peritoneal (PP) single mesh repair, while Group III treated by bilateral Lichtenstein repair. The 3 groups were compared regarding: operative time, postoperative complications, postoperative pain, 3 years-recurrence rate and patient's satisfaction.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Laparoscopic Trans-Abdominal Pre-Peritoneal (Lap TAPP group)) | Active Comparator | Both hernias were treated by laparoscopic trans-abdominal pre-peritoneal repair using 2 separate meshes fixed by endoscopic tackers |
|
| Open Pre-Peritoneal Repair ( Open PP group) | Active Comparator | Both hernias were treated by open pre-peritoneal single mesh repair with suture fixation |
|
| Bilateral Lichtenstein repair (LICHT group) | Active Comparator | treated by bilateral standard Lichtenstein repair using 2 separate meshes with suture fixation |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Laparoscopic Trans-Abdominal Pre-Peritoneal | Procedure | Laparoscopic trans-abdominal pre-peritoneal repair using 2 separate meshes fixed by endoscopic tackers |
|
| Measure | Description | Time Frame |
|---|---|---|
| Operative time | Operative time (in minutes) | From skin incision until incision closure at the end of surgery |
| Postoperative pain after 24 hours | Pain intensity was assessed 24 hours after surgery using the pain visual analogue scale (VAS) with values ranging from 1 (no pain) to 10 (worst possible pain) | 24 hours after surgery |
| Postoperative pain after 7 days | Pain intensity was assessed 7 days after surgery using the pain visual analogue scale (VAS) with values ranging from 1 (no pain) to 10 (worst possible pain) | 7 days after surgery |
| Early postoperative complications | All complication related to surgery developed within 30 days after the surgery | Within 30 days after the surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Chronic Groin pain | Groin pain lasting for more than 3 months after surgery | After 3 months postoperatively |
| 3 years hernia recurrence rate | Unilateral or bilateral - residual or recurrent hernia |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Mohamed Elmessiry, MD, PhD | Assistant Professor of Surgery | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 11525372 | Background | Sarli L, Iusco DR, Sansebastiano G, Costi R. Simultaneous repair of bilateral inguinal hernias: a prospective, randomized study of open, tension-free versus laparoscopic approach. Surg Laparosc Endosc Percutan Tech. 2001 Aug;11(4):262-7. doi: 10.1097/00129689-200108000-00007. | |
| 20960019 | Background | Feliu X, Claveria R, Besora P, Camps J, Fernandez-Sallent E, Vinas X, Abad JM. Bilateral inguinal hernia repair: laparoscopic or open approach? Hernia. 2011 Feb;15(1):15-8. doi: 10.1007/s10029-010-0736-2. Epub 2010 Oct 21. |
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Sealed opaque envelopes containing computer generated random numbers
| Open pre-peritoneal repair | Procedure | Open pre-peritoneal single mesh repair with suture fixation |
|
| Bilateral Lichtenstein repair | Procedure | Bilateral standard Lichtenstein repair using 2 separate meshes with suture fixation |
|
| within 3 years after surgery |
| Patient's satisfaction score | Patient satisfaction was assessed using 1 to 10 scale where: 9-10 means very satisfied, 7-8: satisfied, 6-7: neutral, 4-5: dissatisfied, <4: very dissatisfied | within 3 years after surgery |