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

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.