Skip to main content
PMC home page
Annals of Surgery logoLink to Annals of Surgery
. 1996 Mar;223(3):249–252. doi: 10.1097/00000658-199603000-00004

Simultaneous repair of bilateral inguinal hernias under local anesthesia.

P K Amid 1, A G Shulman 1, I L Lichtenstein 1
PMCID: PMC1235112  PMID: 8604904

Abstract

OBJECTIVE: The authors confirm the advantages of simultaneous repair of bilateral inguinal hernias, indicate that it is feasible to perform the procedure under local anesthesia, and suggest that when an open tension-free technique is used, the results are superior to those of laparoscopic repair of bilateral inguinal hernias. SUMMARY BACKGROUND DATA: Between 1971 and 1995, simultaneous repair of bilateral inguinal hernias were performed in 2953 men. Initially, between 1971 and 1984, patients with indirect hernias underwent the traditional tissue approximation repair. Those with direct hernias had the same procedure, with the repair additionally buttressed by a sheet of Marlex mesh (Davol, Inc., Cronston, RI). Between 1984 and 1995, both direct and indirect hernias were repaired using the open tension-free hernioplasty procedure. METHOD: The 2953 patients underwent simultaneous repair of bilateral inguinal hernias under local anesthesia in a private practice setting in general hospitals. RESULTS: In those cases in which the "tension free" technique was used, patients experienced minimal to mild postoperative pain and had a short recovery period, with a recurrence rate of 0.1%. CONCLUSIONS: Uncomplicated bilateral inguinal hernias in adults are best treated simultaneously. It is feasible to perform the operation under local anesthesia, and when an open tension-free repair is used, postoperative pain and recovery periods are equally comparable with those of laparoscopic repair, although the complication and the recurrence rates are significantly less.

Full text

PDF
249

Images in this article

250Figure 1.
on p.250
251Figure 2.
on p.251
251Figure 3.
on p.251

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Amid P. K., Shulman A. G., Lichtenstein I. L. A critical comparison of laparoscopic hernia repair with Lichtenstein tension-free hernioplasty. Med J Aust. 1994 Aug 15;161(4):239–241. doi: 10.5694/j.1326-5377.1994.tb127415.x. [DOI] [PubMed] [Google Scholar]
  2. Amid P. K., Shulman A. G., Lichtenstein I. L. Critical scrutiny of the open "tension-free" hernioplasty. Am J Surg. 1993 Mar;165(3):369–371. doi: 10.1016/s0002-9610(05)80847-5. [DOI] [PubMed] [Google Scholar]
  3. Amid P. K., Shulman A. G., Lichtenstein I. L. Local anesthesia for inguinal hernia repair step-by-step procedure. Ann Surg. 1994 Dec;220(6):735–737. doi: 10.1097/00000658-199412000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Arregui M. E., Navarrete J., Davis C. J., Castro D., Nagan R. F. Laparoscopic inguinal herniorrhaphy. Techniques and controversies. Surg Clin North Am. 1993 Jun;73(3):513–527. doi: 10.1016/s0039-6109(16)46034-2. [DOI] [PubMed] [Google Scholar]
  5. Cahlin E., Weiss L. Results of postoperative clinical examination of inguinal hernia after three years. Acta Chir Scand. 1980;146(6):421–426. [PubMed] [Google Scholar]
  6. Cornell R. B., Kerlakian G. M. Early complications and outcomes of the current technique of transperitoneal laparoscopic herniorrhaphy and a comparison to the traditional open approach. Am J Surg. 1994 Sep;168(3):275–279. doi: 10.1016/s0002-9610(05)80201-6. [DOI] [PubMed] [Google Scholar]
  7. Duvie S. O. One-stage bilateral inguinal herniorrhaphy in the adult. Can J Surg. 1984 Mar;27(2):192–193. [PubMed] [Google Scholar]
  8. Fitzgibbons R. J., Jr, Camps J., Cornet D. A., Nguyen N. X., Litke B. S., Annibali R., Salerno G. M. Laparoscopic inguinal herniorrhaphy. Results of a multicenter trial. Ann Surg. 1995 Jan;221(1):3–13. doi: 10.1097/00000658-199501000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Ger R., Omar A. M., Moza S. K. Bilateral adult inguinal hernia. One-stage or two-stage operation? J R Coll Surg Edinb. 1978 Sep;23(5):300–302. [PubMed] [Google Scholar]
  10. Horton M. D., Florence M. G. Simplified preperitoneal Marlex hernia repair. Am J Surg. 1993 May;165(5):595–599. doi: 10.1016/s0002-9610(05)80442-8. [DOI] [PubMed] [Google Scholar]
  11. Hugh T. B. Laparoscopic hernia repair. Med J Aust. 1993 Aug 2;159(3):151–152. doi: 10.5694/j.1326-5377.1993.tb137776.x. [DOI] [PubMed] [Google Scholar]
  12. Kavic M. S. Laparoscopic hernia repair. Surg Endosc. 1993 May-Jun;7(3):163–167. doi: 10.1007/BF00594099. [DOI] [PubMed] [Google Scholar]
  13. Miller A. R., van Heerden J. A., Naessens J. M., O'Brien P. C. Simultaneous bilateral hernia repair. A case against conventional wisdom. Ann Surg. 1991 Mar;213(3):272–276. doi: 10.1097/00000658-199103000-00016. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Paget G. W. Laparoscopic inguinal herniorrhaphy. A personal audit of 222 hernia repairs. Med J Aust. 1994 Aug 15;161(4):249–253. doi: 10.5694/j.1326-5377.1994.tb127417.x. [DOI] [PubMed] [Google Scholar]
  15. Palumbo L. T., Sharpe W. S. Primary inguinal hernioplasty in the adult. Surg Clin North Am. 1971 Dec;51(6):1293–1307. doi: 10.1016/s0039-6109(16)39583-4. [DOI] [PubMed] [Google Scholar]
  16. Panton O. N., Panton R. J. Laparoscopic hernia repair. Am J Surg. 1994 May;167(5):535–537. doi: 10.1016/0002-9610(94)90252-6. [DOI] [PubMed] [Google Scholar]
  17. Read R. C. Bilaterality and the prosthetic repair of large recurrent inguinal hernias. Am J Surg. 1979 Dec;138(6):788–793. doi: 10.1016/0002-9610(79)90297-6. [DOI] [PubMed] [Google Scholar]
  18. Sandbichler P., Gstir H., Baumgartner C., Furtschegger A., Egender G., Steiner E. Laparoskopische Leistenhernienoperation durch transperitoneale Implantation eines Kunststoffnetzes. Technik und Frühergebnisse. Chirurg. 1994 Jan;65(1):64–67. [PubMed] [Google Scholar]
  19. Tsang S., Normand R., Karlin R. Small bowel obstruction: a morbid complication after laparoscopic herniorrhaphy. Am Surg. 1994 May;60(5):332–334. [PubMed] [Google Scholar]
  20. Wheeler K. H. Laparoscopic inguinal herniorrhaphy with mesh: an 18-month experience. J Laparoendosc Surg. 1993 Aug;3(4):345–350. doi: 10.1089/lps.1993.3.345. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES