Bilateral Inguinal Hernias: A New Effective and Minimally Invasive Surgical Option

It is with great pleasure that I share our latest work conducted with Dr. Jean-François Gillion, recently published in AME Surgical Journal (doi:10.21037/asj-25-80).

I would like to sincerely thank the editorial team for the quality of the review process and for the dissemination of this work. I would also like to express my deep gratitude to the members of the Club Hernie, whose commitment and rigor made the development of this database possible.

Article reference:

Soler M, Gillion JF. Open preperitoneal vs. endoscopic repair for bilateral groin hernias: a registry-based two-arm comparison. AME Surg J. 2026. doi:10.21037/asj-25-80

With this publication, we continue a line of work initiated several years ago on minimally invasive open preperitoneal techniques (OPPs), with the aim of better defining their role in the modern management of groin hernias.

Previous studies have confirmed the feasibility of these techniques, their superiority over the Lichtenstein repair—particularly for primary hernias and in terms of chronic pain—as well as outcomes at least equivalent to endoscopic approaches, both in the short and long term.

One key question remained: their role in the management of bilateral hernias.

In this study, based on data from the Club Hernie registry, more than 5,000 patients undergoing simultaneous bilateral hernia repair were analyzed, comparing open preperitoneal techniques (TIPP, MOPP, Ugahary) with endoscopic approaches (TEP/TAPP).

Summary of the study:

In a large multicenter cohort, open preperitoneal techniques demonstrated outcomes comparable to endoscopic approaches in terms of long-term recurrence and chronic pain, despite involving older patients with more complex hernias. Severe complications were rare in both groups, and early postoperative pain differences did not persist over time.

These findings confirm that, even in more complex cases, OPP techniques achieve outcomes equivalent to endoscopic approaches.

Serious complications remain rare, and although early postoperative pain may be slightly lower with endoscopic techniques, this difference rapidly diminishes.

These data suggest that open preperitoneal techniques represent a credible and robust posterior alternative, including for the treatment of bilateral hernias.

To preserve the value of the full article, only a brief overview is provided here. I encourage you to read the full publication on the publisher’s website to fully appreciate its methodological rigor and clinical relevance.

This publication marks another step forward in the recognition of minimally invasive open preperitoneal techniques (OPPs), which now have a clear place in a modern, personalized treatment strategy tailored to patient characteristics, hernia complexity, and surgeon expertise.

Read the full article:

Soler M, Gillion JF. AME Surg J. 2026. doi:10.21037/asj-25-80