Abstract
OBJECTIVE: This study evaluates the long-term safety, efficacy, and recurrence of laparoscopic totally extraperitoneal (TEP) repair for bilateral inguinal hernias using a dual-mesh technique. BACKGROUND: TEP repair is a well-established approach for inguinal hernia, offering advantages such as reduced postoperative pain, faster recovery, and fewer wound complications. METHODS: A retrospective review was conducted of 426 patients with bilateral inguinal hernias who underwent TEP repair between January 2012 and May 2025. All procedures were performed by a single experienced surgeon using the standardized dual-mesh technique. RESULTS: The mean patient age was 48.46 years (range: 17-82). The mean operative time was 47.73 minutes, and the hospital stay was 27.45 hours. The mean follow-up was 74.2 months (range: 12-188). The overall complication rate was low: 34 (7.9%) cases of seroma, urinary retention 2 (0.47%), hematoma 6 (1.4%), hydrocele 3 (0.7%), and no mesh-related infections or chronic pain. Four recurrences (0.94%) were detected, attributed mainly to incomplete dissection, overlooked cord lipomas, or mesh shrinkage. No complications were attributable to the overlapping dual-mesh technique. No intensive care admissions, or deaths occurred. CONCLUSION: Laparoscopic TEP repair with the novel dual-mesh technique provides reliable reinforcement of the myopectineal orifice (MPO), yielding low recurrence rates while avoiding vascular injury or mesh-related complications.