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Laparoscopic TEP Using 3D Mesh to Treat Bilateral Inguinal Hernia
after surgery. The study of Ayyaz et al. showed that for the experience at a tertiary care hospital in Kashmir, India. Int Surg J
group of patients with mesh fixation, the average pain level 2018;5(3):1016–1020. DOI: 10.18203/2349-2902.isj20180822.
was 4.7 ± 0.68, which was significantly higher than the group of 5. Hanif Z, Sajid MA, Kumaran RP, et al. Modification of standard
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patients without mesh fixation at 4.1 ± 0.86 with p <0.001. In laparoscopic total extra peritoneal hernia repair technique: methods
our study, with most cases without mesh fixation, the average to improve feasibility in the UK health service. Int J Surg Open
2017;9:45–47. DOI: 10.1016/j.ijso.2017.10.001.
postoperative pain time of 2.2 ± 1.5 days was observed, which 6. Krishna A, Bansal VK, Misra MC, et al. Totally extraperitoneal repair in
was similar to other studies. inguinal hernia: more than a decade’s experience at a tertiary care
Early complications after TEP laparoscopic surgery might hospital. Surg Laparosc Endosc Percutan Tech 2019;29(4):247–251.
include urinary retention, epididymitis, wound infection, DOI: 10.1097/SLE.0000000000000682.
hematoma, fluid accumulation, and chronic pain in the groin– 7. Chowbey PK, Garg N, Sharma A, et al. Prospective randomized
scrotum. 14,17 According to Gass, patients undergoing bilateral TEP clinical trial comparing lightweight mesh and heavyweight
2
endoscopy had an early complication rate of 3.2%. This rate in the polypropylene mesh in endoscopic totally extraperitoneal groin
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study of Kockerling was 1.82%. In our study, early complications hernia repair. Surg Endosc 2010;24(12):3073–3079. DOI: 10.1007/
s00464-010-1092-0.
were found in 10.0% of patients. 8. Poobalan AS, Bruce J, Smith WCS. A review of chronic pain
All patients were followed for a mean of 21.4 ± 11.8 months after inguinal herniorrhaphy. Clin J Pain 2003;19(1):48–54. DOI:
(minimum 1 month, maximum 40 months). One patient (2.1%) 10.1097/00002508-200301000-00006.
was observed with chronic pain in the groin area, who also had 9. Bell RCW, Price JG. Laparoscopic inguinal hernia repair using an
prolonged pain after surgery, possibly due to the process of anatomically contoured three-dimensional mesh. Surg Endosc
dissection or mesh fixation in the surgery, causing damage to the 2003;17(11):1784–1788. DOI: 10.1007/s00464-002-8763-4.
nerve branch. The rate of chronic pain after inguinal hernia ranged 10. Wauschkuhn CA, Schwarz J, Boekeler U, et al. Laparoscopic inguinal
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from 1 to 63%. For this patient, at the time of follow-up after 1 hernia repair: gold standard in bilateral hernia repair? Results of
and 3 months, the pain reduced gradually but still made the patient more than 2,800 patients in comparison to literature. Surg Endosc
2010;24(12):3026–3030. DOI: 10.1007/s00464-010-1079-x.
feel uncomfortable. The patient was treated with pain relievers, 11. Lal P, Philips P, Chander J, et al. Is unilateral laparoscopic TEP inguinal
anti-inflammatory drugs, and the pain gradually decreased after hernia repair a job half done? The case for bilateral repair. Surg Endosc
5 months. 2010;24(7):1737–1745. DOI: 10.1007/s00464-009-0841-4.
12. Pfeffer F, Riediger H, Lein RK, et al. Repair of bilateral inguinal hernias:
sequential or simultaneous? Zentralbl Chir 2008;133:446–451. DOI:
conclusIon 10.1055/s-2008-1076959.
TEP laparoscopic surgery using 3D mesh is a safe, feasible, and 13. Patel KH, Gohel JB, Patel BJ. Managing bilateral inguinal hernia
effective method in bilateral inguinal hernia in adults, with low rates laparoscopically: is it gold standard? Int Surg J 2017;4(1):296–299.
of complications and recurrences. However, with the limited sample DOI: 10.18203/2349-2902.isj20164458.
size and follow-up time of the study, it is necessary to perform 14. Acar A, Kabak I, Tolan HK, et al. Comparison between mesh fixation
and non‐fixation in patients undergoing total extraperitoneal
further studies with a larger sample size and longer follow-up time inguinal hernia repair. Niger J Clin Pract 2020;23(7):897–899. DOI:
to evaluate the effectiveness of this method. 10.4103/njcp.njcp_398_19.
15. Köckerling F, Schug-Pass C, Adolf D, et al. Bilateral and unilateral total
extraperitoneal inguinal hernia repair (tep) have equivalent early
references outcomes: analysis of 9395 cases. World J Surg 2015;39(8):1887–1894.
1. Talha AR, Shabban A, Ramadan R. Preperitoneal versus Lichtenstein DOI: 10.1007/s00268-015-3055-z.
tension-free hernioplasty for the treatment of bilateral inguinal 16. Ayyaz M, Farooka MW, Malik AA, et al. Mesh fixation vs. non- fixation
hernia. Egypt J Surg 2015;34(2):79–84. DOI: 10.4103/1110-1121.155715. in total extra peritoneal mesh hernioplasty. JPMA 2015;65(3):270–272.
2. Gass M, Rosella L, Banz V, et al. Bilateral total extraperitoneal inguinal PMID: 25933559.
hernia repair (TEP) has outcomes similar to those for unilateral TEP: 17. Thảo TV. Nghiên cứu ứng dụng phẫu thuật nội soi đặt mảnh ghép
population-based analysis of prospective data of 6,505 patients. Surg hoàn toàn ngoài phúc mạc trong điều trị thoát vị bẹn: Học viện
Endosc 2012;26(5):1364–1368. DOI: 10.1007/s00464-011-2040-3. Quân Y; 2010.
3. Ger R. The Management of certain abdominal hernias by intra- 18. Hanada K, Narita M, Goto K, et al. Chronic inguinal pain after
abdominal closure of the neck. Ann R Coll Surg Engl 1982;64(5): laparoscopic intraperitoneal onlay mesh (IPOM) repair for inguinal
342–344. PMID: 7114772. hernia treated successfully with laparoscopic selective neurectomy:
4. Mir IS, Rashid T, Mir IN, et al. Laparoscopic totally extraperitoneal a case report. Int J Surg Case Rep 2017;38:172–175. DOI: 10.1016/
repair of inguinal hernia using three-dimensional mesh: a 5 years j.ijscr.2017.07.044.

200 World Journal of Laparoscopic Surgery, Volume 14 Issue 3 (September–December 2021)