The aim of this study is to compare the modified Kugel (M-Kugel) repair with laparoscopic totally extraperitoneal herniorrhaphy (TEP) in patients undergoing surgery for bilateral inguinal hernia.

Clinical data of 157 patients (71 cases in TEP group and 86 cases in M-Kugel group) undergoing herniorrhaphy in Ninth People's Hospital of Shanghai Jiaotong University School of Medicine were analyzed. Outcome parameters included hospital stay, operation time, intraoperative bleeding volume, postoperative complications, immediate postoperative pain and chronic pain, recurrence and quality of life. The SPSS20.0 statistical software was used for data analysis.

The operation time was (93.5±10.9) minutes in the TEP group and (102.6±9.8) minutes in the modified Kugel group, the difference was statistically significant (P<0.05). The length of stay in the TEP group was (1.05±0.21) days, and it was (1.52±0.69) dayd in the modified Kugel group, the difference was statistically significant (P<0.05). Intraoperative blood loss was (22.1±7.1) ml in the TEP group and (23.4±6.8) ml in the modified Kugel group, the difference was not statistically significant (P>0.05). The time to return normal activities after operation was (8.67±2.32) days in the TEP group and (9.14±2.40) days in the modified Kugel group, and there was no significant difference (P>0.05). Postoperative complications were 5 cases (7%) in the TEP group and 10 cases (11.6%) in the modified Kugel group. The difference was not statistically significant (P>0.05). Among the patients with complications, the body mass index was more than 27 kg/m², there was 1 case (20%) in the TEP group and 6 cases (60%) in the modified Kugel group. The difference was not statistically significant (P>0.05). There were 3 cases of chronic pain (4.2%) in the TEP group and 14 cases (16%) in the modified Kugel group. The difference was statistically significant (P<0.05). As of the end of the follow-up, there was no recurrence in the TEP group and 1 recurrence in the modified Kugel group (about 1%); there was no significant difference between the two groups (P>0.05). There was a statistically significant difference in the visual analogue scores of pain between the two groups at 1 and 7 days after surgery (P<0.05); the difference was not statistically significant (P>0.05) between preoperative, postoperative and 12 months. There was no significant difference in the scores of the quality of life scale between the two groups before operation, at 1, 2, 6 and 12 months after operation (P>0.05).

TEP procedure for bilateral inguinal hernia effectively reduces operation time, early postoperative pain, and hospital stay.