This video demonstrates Bilateral Inguinal Hernia Laparoscopic TAPP Repair Performed by Dr. R K Mishra at World Laparoscopy Hospital. A bilateral (meaning both sides) hernia is a type of inguinal or groin hernia that occurs on both sides of the lower abdomen. Hernias may not be painful when they first occur. However if left unattended the weak spot can grow and simple acts like coughing, sneezing, or lifting heavy objects can be painful. In this laparoscopic procedure requiring general anesthesia, the surgeon operates through several small incisions in your abdomen. The surgeon may use laparoscopic or robotic instruments to repair your hernia. Gas is used to inflate your abdomen to make the internal organs easier to see. A small tube equipped with a tiny camera (laparoscope) is inserted into one incision. Guided by the camera, the surgeon inserts tiny instruments through other small incisions to repair the hernia using synthetic mesh. People who have a minimally invasive repair might have less discomfort and scarring after surgery and a quicker return to normal activities. Long-term results of laparoscopic and open hernia surgeries are comparable.

Bilateral inguinal hernia is a common surgical condition where hernias occur on both sides of the groin. With advancements in minimally invasive surgery, Laparoscopic Transabdominal Preperitoneal (TAPP) repair has become a preferred technique for managing bilateral inguinal hernias. This approach offers excellent visualization, reduced postoperative pain, early recovery, and simultaneous repair of both hernias through the same port sites.

Understanding Bilateral Inguinal Hernia

Inguinal hernias develop due to weakness in the abdominal wall, allowing abdominal contents to protrude through the inguinal canal. When present on both sides, it is termed bilateral inguinal hernia, which may be direct, indirect, or a combination of both.

Common Symptoms

Groin swelling on both sides

Discomfort or pain, especially on exertion

Heaviness in the groin region

Occasionally asymptomatic and detected incidentally

Why Choose Laparoscopic TAPP Repair?

Laparoscopic TAPP repair involves entering the abdominal cavity and placing a mesh in the preperitoneal space after reducing the hernia sac. It is especially advantageous for bilateral hernias, as both sides can be repaired during the same procedure without additional incisions.

Advantages of TAPP Repair

Single-stage repair of bilateral hernias

Excellent anatomical visualization

Less postoperative pain

Faster return to normal activity

Lower incidence of chronic groin pain

Better cosmetic results

Surgical Technique of TAPP Repair
1. Patient Preparation

The patient is placed in the supine position under general anesthesia. Pneumoperitoneum is created, and laparoscopic ports are inserted.

2. Peritoneal Incision

A peritoneal flap is created above the hernia defect, exposing the preperitoneal space.

3. Hernia Sac Reduction

Both direct and indirect hernia sacs are carefully identified and reduced. Special attention is given to protect vital structures such as the inferior epigastric vessels, spermatic cord, and nerves.

4. Mesh Placement

A large polypropylene or composite mesh is placed to cover the myopectineal orifice on both sides, ensuring adequate overlap of hernia defects.

5. Mesh Fixation and Peritoneal Closure

The mesh may be fixed using tackers, sutures, or glue. The peritoneal flap is then closed to prevent bowel adhesion.

Postoperative Care and Recovery

Early ambulation on the same day

Oral intake resumed within hours

Discharge usually within 24 hours

Return to routine activities within a few days

Avoid heavy lifting for a few weeks

Possible Complications

Although rare, complications may include:

Seroma or hematoma

Urinary retention

Mesh infection

Chronic groin pain

Recurrence (low with proper technique)

Conclusion

Laparoscopic TAPP repair is a safe, effective, and patient-friendly approach for the management of bilateral inguinal hernia. Its ability to repair both sides simultaneously with minimal morbidity makes it the procedure of choice for many surgeons and patients. With proper surgical expertise, TAPP repair offers excellent long-term outcomes and rapid recovery.

Contact us at

World Laparoscopy Hospital
Cyber City, Gurugram,
NCR Delhi
INDIA: +919811416838

World Laparoscopy Training Institute
Bld.No: 27, DHCC, Dubai
UAE: +971525857874

World Laparoscopy Training Institute
8320 Inv Dr, Tallahassee, Florida
USA: +1 321 250 7653