A Prospective Observational Study of Laparoscopic Extended Totally Extraperitoneal (e-TEP) Repair for Bilateral Inguinal Hernia at Tertiary Care Teaching Centre

IntroductionInguinal hernia is a common surgical condition that affects both men and women worldwide.Laparoscopic approaches, particularly the extended totally extraperitoneal (e-TEP) technique, have gained popularity owing to their minimally invasive nature, which reduces postoperative pain, hospital stay, and recovery time.Despite these advantages, comprehensive literature on the efficacy of e-TEP, particularly for bilateral inguinal hernias, remains limited. ObjectiveThe study aims to evaluate the short-term perioperative outcomes or clinical outcomes of laparoscopic extended e-TEP procedure in bilateral inguinal hernia repair. Materials and methodsA prospective observational study was conducted from June 2022 to December 2023 at the Department of General Surgery of Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow.Patients with clinical or radiological evidence of bilateral inguinal hernia, aged >15 years, and undergoing laparoscopic hernia repair were included.The exclusion criteria encompassed patients unfit for general anesthesia, those with prior lower abdominal surgery, pregnancy, lower abdominal malignancy, complicated hernia, morbid obesity (BMI ≥40), and recurrent hernia.Data collected included demographic information, clinical characteristics, and surgical outcomes.A laparoscopic extended totally extraperitoneal repair was performed using standard guidelines with two 15×12 cm polypropylene meshes. ResultsThe mean operative time was 109.16±14.53min.Postoperative pain, assessed using visual analog scale (VAS), was significantly reduced from day 0 (3.48±0.641) to day 1 (2.29±0.536)at rest, and from 4.88±0.784to 2.31±0.544during ambulation.The hospital stay lasted two to three days.Minimal intraoperative complications were noted, with peritoneal rent occurring in only one case.Postoperative complications were also minimal, with 11 patients experiencing port-site pain and nine developing seromas. ConclusionLaparoscopic eTEP repair for bilateral inguinal hernia showed favourable short-term outcomes in this singlecentre observational study, including acceptable operative time, low early postop pain scores, minimal intraoperative complications and hospital stay.This study underscores the need for further research with larger sample sizes and long-term follow-up to validate these findings and enhance clinical practice for bilateral inguinal hernia repair.