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Purpose <p>To 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.</p> Methods <p>A 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&#xa0;months) and late (&gt; 12&#xa0;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.</p> Results <p>A total of 244 patients (488 hernias) met the inclusion criteria, with a median follow-up of 116&#xa0;months. OPA patients were older and had more comorbidities (<i>P</i> &lt; 0.001). Operative time was shorter in the OPA group (median 70 vs. 110&#xa0;min; <i>P</i> &lt; 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&#xa0;months postoperatively (OR 0.091, <i>P</i> &lt; 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, <i>P</i> = 0.024).</p> Conclusion <p>OPA is a safe and effective technique for BGH repair, offering shorter operative times and lower risk of CPIP between 3–12&#xa0;months postoperatively compared to MIS, while maintaining comparable long-term outcomes (&gt; 12&#xa0;months).</p>

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Ambulatory bilateral groin hernia repair: open preperitoneal versus laparoscopic outcomes

  • 期刊论文

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  • 发表日期：

    2025年11月24日

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  • Maria Jose Gomez-Jurado,
  • Mireia Verdaguer-Tremolosa,
  • Victor Rodrigues-Gonçalves,
  • Pilar Martínez-López,
  • María Martínez-López,
  • Meritxell Pera,
  • Mar Dalmau,
  • Manuel López-Cano

摘要

Purpose

To 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.

Methods

A 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.

Results

A 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).

Conclusion

OPA 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).