Study to Compare Bilateral Lichtenstein Repair with Stoppa’s (Giant Prosthetic Reinforcement of The Visceral Sac) Repair in Cases of Bilateral Inguinal Hernia

Author(s): Jai Prakash, Rajiv Nandan Sahai

Introduction: Inguinal hernia is most common form of hernia occurring in almost 1-5% of the population of which 6-8% occur bilaterally. The average age of patients with bilateral hernia is usually > 50 years and a male to female ratio is of 6:1.

It has been proven beyond doubt that placement of a mesh is needed in all types of tension free repair. There are numerous options for mesh repair for bilateral inguinal hernia: Lichtenstein’s; Stoppa’s, TEP/TAPP. Of these, Stoppa’s and laparoscopic repairs strengthen the Myopectineal orifice while Lictenstein’s just strengthens the posterior wall.

Another point of contention for a long time has been whether to repair the bilateral inguinal hernias sequentially or simultaneously keeping in mind that majority of patients are males who are > 50 years of age and are at a higher risk for anesthesia and operative time.

Aim: To compare the outcomes of bilateral inguinal hernia repair between patients who underwent Stoppa’s repair to those who underwent simultaneous bilateral Lichtenstein’s repair.

Materials and Methods: Prospective interventional comparative study conducted in Department of Hindu Rao Hospital, Delhi in which 60 patients with bilateral inguinal hernia who underwent bilateral Lichtenstein repair in a single sitting and Stoppa’s repair.

Results: Mean duration of surgery for Lichtenstein is 67.03 min which is significantly more than 53.2 min for Stoppa’s repair (pvalue, i.e. <0.0001). Post-op pain on Day 0 & 1 was less in Stoppa’s repair as compared to Lichtenstein repair.

Average hospital stay was 3.23 days in Lichtenstein repair and 3.0