Comparison of Stoppa and Lichtenstein techniques in the repair of bilateral inguinal hernias

Abstract

The feasibility of tension-free repairs in bilateral inguinal hernias has not been well documented. In this prospective randomized study patients' characteristics, intra- and postoperative parameters including pain, return to daily activity and work, were assessed in patients undergoing bilateral hernia repair by means of either the Stoppa or the Lichtenstein techniques. A total of 45 patients having bilateral inguinal hernia repairs were randomly assigned to one of the two treatment groups. Patients in Group I had operations with the simultaneous Lichtenstein technique (n:23) and were further randomized to either spinal (n:11) or local anesthesia (n:12) sub-groups. Those in Group II underwent a Stoppa hernioplasty (n:22). Complications and recurrences were sought for two years postoperatively. Patients with bilateral Lichtenstein repair under local anesthesia had lower pain scores at rest and leg-raising test, and returned to pain-free normal daily activity and work on the 15th and 30th days, respectively. Although smaller than those of other groups, none of these parameters were statistically significant. The only prominent difference was seen in the operating time. The Stoppa repair took significantly less time than the Lichtenstein repairs (51 vs. 65 min, p < 0.01). In this study we were unable to demonstrate the superiority of either technique or type of anesthesia used in the repair of bilateral hernias. Both techniques were capable of producing favorable postoperative results, and were well accepted by most of the patients.