Early outcomes of laparoscopic totally extraperitoneal repair with protack mesh fixation for bilateral inguinal hernia

Early outcomes of laparoscopic totally extraperitoneal repair with protack mesh fixation for bilateral inguinal hernia

Authors

  • Tuan Tu Duong Department of General Surgery, Can Tho General Hospital, Can Tho, Vietnam
  • Hong Quan Dang Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
  • Van Phu La Department of General Surgery, Can Tho General Hospital, Can Tho, Vietnam; Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam

Keywords:

bilateral inguinal hernia, totally extraperitoneal repair, TEP, mesh fixation, ProTack

Abstract

Background: Bilateral inguinal hernia accounts for 15-20% of all inguinal hernias. The role of mesh fixation during laparoscopic totally extraperitoneal (TEP) repair for bilateral inguinal hernia remains controversial. This study evaluated the clinical characteristics, European Hernia Society (EHS) classification, and early outcomes of laparoscopic TEP repair with ProTack mesh fixation for bilateral inguinal hernia.

Methods: A prospective descriptive study included 45 patients with bilateral inguinal hernia who underwent laparoscopic TEP repair with ProTack mesh fixation at Can Tho General Hospital between July 2025 and May 2026.

Results: The mean age was 64.8 ± 10.9 years, and all patients were male. Direct hernias accounted for 65.6% of all hernia sacs, while M2 was the most common EHS subtype (46.7%). The mean operative time was 67.1 ± 16.8 minutes. Peritoneal tears and spermatic vessel injuries occurred in 35.6% and 13.3% of patients, respectively. Mean VAS scores decreased from 2.93 ± 0.86 at 24 hours to 1.33 ± 0.50 at 72 hours. Mean postoperative hospital stay was 1.58 ± 0.78 days. Early complications included seroma (11.1%) and urinary retention (4.4%). At follow-up, only one patient (3.2%) reported mild groin paresthesia. No conversion, chronic pain, mesh infection, or recurrence was observed. The overall success rate was 100%.

Conclusions: Laparoscopic TEP repair with ProTack mesh fixation demonstrated favorable early clinical outcomes and appears to be a feasible and safe approach for bilateral inguinal hernia. 

Author Biographies

Tuan Tu Duong, Department of General Surgery, Can Tho General Hospital, Can Tho, Vietnam

Department of General Surgery, Can Tho General Hospital, Can Tho, Vietnam

Hong Quan Dang, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam

Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam

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Published

07-08-2026

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ORIGINAL RESEARCH ARTICLE

How to Cite

1.
Duong TT, Dang HQ, La VP. Early outcomes of laparoscopic totally extraperitoneal repair with protack mesh fixation for bilateral inguinal hernia. Acta Biomed. 2026;97(4):19280. doi:10.23750/abm.2026.19280