Our Summary

This research paper is about comparing the risks of two types of hernia repair surgeries: one that fixes hernias on both sides of the groin (bilateral) and one that fixes a hernia on just one side (unilateral). The technique used for these surgeries is called a laparoscopic total extra-peritoneal (TEP) operation, which is a type of minimally invasive surgery.

The researchers looked at studies published up to the end of 2021 and found eight that met their criteria. They included data from 18,153 patients who were at least 16 years old and who had either a unilateral or bilateral TEP operation. They looked at several factors, like how long the operation took, whether the surgery had to be switched to a traditional open surgery, and how long the patient stayed in the hospital.

The results showed that the bilateral surgery took longer than the unilateral surgery. It also had a higher rate of hernias coming back. However, there were no significant differences in the other factors.

The researchers note that the studies they looked at weren’t the highest quality of evidence because they were observational studies, meaning they just watched what happened rather than conducting a controlled experiment. They recommend that randomized controlled trials (the gold standard in medical research) should be done on this topic.

FAQs

  1. What are the two types of hernia repair surgeries discussed in this research paper?
  2. What factors did the researchers consider when comparing the two types of hernia repair surgeries?
  3. What were the key findings from the studies comparing bilateral and unilateral TEP operations?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hernia repair is to discuss with their surgeon the risks and benefits of both unilateral and bilateral TEP operations. It’s important to understand that while bilateral surgery may take longer and have a higher risk of hernia recurrence, it may still be the best option for some patients. It’s important to have an open and honest conversation with your surgeon to determine the best approach for your specific situation.

Suitable For

Patients who are typically recommended hernia repair include those who have symptomatic hernias, which can cause pain, discomfort, and other complications. Additionally, patients with hernias that are at risk of complications such as obstruction or strangulation are also recommended for hernia repair. Patients who are healthy enough to undergo surgery and who have realistic expectations about the procedure and recovery process are also good candidates for hernia repair.

Timeline

Before hernia repair:

  • Patient may experience pain or discomfort in the affected area
  • Consultation with a healthcare provider to determine the need for surgery
  • Pre-operative tests and evaluations to assess overall health and fitness for surgery
  • Discussion of surgical options, including the choice between unilateral and bilateral repair
  • Informed consent process to understand risks and benefits of the surgery

After hernia repair:

  • Recovery period with restrictions on physical activity
  • Pain management and monitoring for any signs of infection or complications
  • Follow-up appointments with the surgeon to assess healing and address any concerns
  • Gradual return to normal activities and exercise
  • Long-term follow-up to monitor for recurrence of the hernia or any other issues

What to Ask Your Doctor

  1. What are the potential risks and complications associated with bilateral hernia repair compared to unilateral hernia repair?
  2. How long is the recovery time expected to be for each type of surgery?
  3. Are there any specific factors that make me a better candidate for one type of surgery over the other?
  4. How experienced are you in performing both unilateral and bilateral hernia repair surgeries?
  5. What is the success rate of each type of surgery in terms of preventing hernia recurrence?
  6. Will I need to stay in the hospital overnight after either type of surgery?
  7. What are the potential long-term effects or complications that could arise from either type of surgery?
  8. How will the pain management differ between unilateral and bilateral hernia repair surgeries?
  9. Are there any lifestyle changes or restrictions I need to be aware of following either type of surgery?
  10. What are the potential costs associated with each type of surgery, including any follow-up appointments or treatments that may be needed?

Reference

Authors: Hitman T, Bartlett ASR, Bowker A, McLay J. Journal: Hernia. 2023 Oct;27(5):1047-1057. doi: 10.1007/s10029-023-02785-0. Epub 2023 Apr 3. PMID: 37010657