الفهرس 
Anatomy of inguinal canalOnly 14 pages are availabe for public view
 |  | from | 83 |  |  |
| | | from | 83 | | |
Abstract
A special entity among inguinal hernias is represented by bilateral
hernia. many researches focused on identifying the grade of particularity of
this entity (is it a simple double hernia or a special type of hernia?)
(Gavrilas , et al.2008)
There is no ”gold standard” operation for treatment of bilateral
inguinal hernias. The optimal surgical approach must be selected
individually for the patient, taking into account patient age, hernia size,
primary or recurrent status, type of anesthesia, occupation, and patient
activities.
There are three important landmarks in the history of repair of
bilateral inguinal hernia:
1. Tissue repair (Eduardo Bassini 1889).
2. Onlay mesh (Irving Lichtenstein1984) ,tension-free repair, stoppa repair.
3. Laparoscopic hernia repair (1990).
Laproscopic repair of bilateral inguinal hernia includes both TAPP
and TEP approach.
Our study is aiming to evaluate and compare STOPPA &
laparoscopic (TAPP) in management of bilateral inguinal hernia in regards
to : Operative time, Hospital stay, Post - operative infection ,Respiratory
embarrassment, recurrence ,post –operative pain, Quality of life.
This study was done at Menoufiya university hospital over a period
from february 2017 – to february 2018, It included 40 patients
complaining of bilateral inguinal hernia who were fit for surgery.
Patients were randomly divided into two groups:
group I under went TAPP repair .
group II under went Stoppa repair .
These patients presented in the outpatient clinics at Menoufyia university
hospitals, and distributed into 2 groups randomly.
All the two groups were compared for:
• Operative duration.
• Intra-operative complications.
• Postoperative pain.
• Postoperative hospital stay.
• The mean time until return to work.
• Postoperative complications.
In patients who underwent bilateral inguinal hernia repair by
TAPP, the mean age was 38.5 years, the mean operative time was
82.41min., the hospital stay was one day in all cases, with one recurrent
case and they returned to work after 15 +/- 5 days.
In patients who underwent bilateral inguinal hernia repair by
STOPPA, the mean age was 43.15 years, the mean operative time was
103.36 min, the hospital stay ranged from 1 to 3 days, with three cases of
recurrence and they returned to work after 25 +/- 5 days.In this study the difference between the two groups regarding
postoperative recurrence was statistically insignificant, as one recurrent
case in group I (5%), three cases recurrent in group II (15%), recurrence
occur in group II may be due to mesh migration or not fixing the mesh.
In this study the differences between the two groups regarding
postoperative pain statistically significant, as two cases in group II
complaining of severe pain postoperative (10%) while no cases presented
with severe pain in group I. On the other hand nine cases in group II
(45%) has mild pain in comparison with two cases in group I (10%)