ArticleHernia : the journal of hernias and abdominal wall surgery2025
Ambulatory bilateral groin hernia repair: open preperitoneal versus laparoscopic outcomes.
Article in Hernia : the journal of hernias and abdominal wall surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.
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- Erratum issued
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8 authors.
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Abstract
purposeTo evaluate short and long-term outcomes of bilateral groin hernia (BGH) repair using an open preperitoneal approach (OPA) compared to minimally invasive surgery (MIS) in ambulatory surgery.
methodsA retrospective cohort study was conducted including patients undergoing ambulatory BGH repair between 2010 and 2018 at Vall d'Hebron University Hospital (Barcelona) using either OPA (a modified Wantz technique) or MIS [transabdominal preperitoneal (TAPP) or totally extraperitoneal (TEP)]. Demographic, perioperative, and postoperative data were analysed. Chronic postoperative inguinal pain (CPIP) was assessed at two time points: early (3-12 months) and late (> 12 months postoperatively). Long-term follow-up was conducted through structured telephone interviews using the Hernia Recurrence Inventory survey. Multivariate logistic regression and ROC analysis were used to identify predictors of CPIP.
resultsA total of 244 patients (488 hernias) met the inclusion criteria, with a median follow-up of 116 months. OPA patients were older and had more comorbidities (P < 0.001). Operative time was shorter in the OPA group (median 70 vs. 110 min; P < 0.001). No significant differences were found in recurrence rates or surgical site occurrences. Multivariate analysis showed that OPA was independently associated with a lower risk of CPIP between 3-12 months postoperatively (OR 0.091, P < 0.001) compared to MIS. At long-term follow-up, higher Body Mass Index (BMI) was the only factor associated with persistent pain (OR 1.2, P = 0.024).
conclusionOPA is a safe and effective technique for BGH repair, offering shorter operative times and lower risk of CPIP between 3-12 months postoperatively compared to MIS, while maintaining comparable long-term outcomes (> 12 months).
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