Five Synchronous Groin Hernias (Bilateral Lateral and Femoral and Right Medial) Repaired in a Single Laparoscopic Transabdominal Preperitoneal Session: A Case Report

TL;DR

A rare case of five simultaneous groin hernias was successfully repaired in one laparoscopic surgery.

Contribution

Demonstrates the successful single-stage repair of five synchronous groin hernias using laparoscopic TAPP.

Findings

Five hernias (right M3, L1, F2; left L1, F3) were identified and repaired in one laparoscopic session.

The patient had no complications and no recurrence at follow-up.

TAPP allows comprehensive evaluation and repair of multiple, often hidden, hernias in one operation.

Abstract

Concomitant bilateral inguinal and femoral hernias are exceptionally rare, and most reports describe no more than three simultaneous groin defects. We report a 65-year-old male with a clinically diagnosed right groin bulge. During laparoscopic transabdominal preperitoneal (TAPP) exploration, the first intraperitoneal survey showed a right medial inguinal hernia (M3) and a right lateral inguinal hernia (L1), together with a left lateral inguinal hernia (L1) (European Hernia Society classification). After systematic dissection of both myopectineal orifices (MPOs), three additional occult hernias were identified, yielding five defects in total: right M3, L1, and femoral F2, plus left L1 and femoral F3. Each MPO was repaired with an anatomically contoured mid-weight polypropylene mesh (10 × 16 cm) with ≥3 cm overlap beyond all defect margins and secured using absorbable tackers. Recovery was uneventful. The patient was discharged on postoperative day three with no recurrence or complications at the latest follow-up. This case illustrates the diagnostic and therapeutic advantages of TAPP for comprehensive bilateral MPO evaluation and single-stage repair of multiple, often occult, groin hernias.

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