Previous research has shown that the repair of a recurrent inguinal hernia is subject to a greater risk of additional recurrence. Further, bilateral inguinal hernia is subject to a greater recurrence risk than unilateral inguinal hernia. These increased risks may be due to certain anatomical difficulties that complicate the surgical approach in these types of patients. Some clinicians have suggested that laparoscopic approaches are better suited to recurrent and bilateral hernias, and in we delineate separate comparisons for primary, bilateral, and recurrent hernia.
We analyzed medical records of 454 patients undergoing inguinal hernia repair with local anesthesia on an outpatient basis between November 2004 and August 2008, all operated by the technique of Lichtenstein associated with intravenous sedation in The First Surgical Clinic of Bonsucesso General Hospital , in Rio de Janeiro.Of all patients operated, 22 (4.8%) were female and 432 (95.2%) male. We performed 285 hernioplasties on the right (62.8%), 163 (35.9%) on the left and six bilateral (1.3%). With respect to the Nyhus classification, 55% of cases were classified as type II, 24% type III-A, 14% type III-B and 7% type I.