From the Research
Herniotomy with contralateral exploration is not recommended for adult patients with unilateral inguinal hernia, as the risks of complications and unnecessary repairs outweigh the potential benefits, according to the most recent and highest quality study 1. The procedure typically involves:
- Making a small incision in the affected groin area
- Repairing the hernia on the symptomatic side
- Exploring the contralateral side through the same incision or a separate small incision
- Repairing any occult hernia found on the opposite side However, the evidence suggests that contralateral exploration and repair of occult inguinal hernias during laparoscopic inguinal hernia repair is not warranted in patients with occult hernias diagnosed at the time of elective hernia repair, due to the high risk of bias in the available studies 1. Justification for this approach:
- The incidence of occult contralateral inguinal hernias is relatively low, ranging from 7.3-50.1% per cent 1
- The risk of postoperative complications is significant, with 10.5% of patients experiencing complications after repair 1
- Expectant management may be a viable alternative, as 29% of patients managed expectantly later required elective repair for symptoms, but this approach avoids the risks associated with unnecessary repairs 1 Post-operative care typically involves pain management with acetaminophen or ibuprofen, wound care, and activity restrictions for 1-2 weeks. Follow-up should occur within 1-2 weeks to assess healing and address any concerns. It's worth noting that the evidence is largely based on observational studies at high risk of bias, and the results should be interpreted with caution. However, the most recent and highest quality study 1 suggests that contralateral exploration and repair is not recommended for adult patients with unilateral inguinal hernia.