A prospective and retrospective study of Stoppa procedure (giant prosthetic reinforcement of visceral sac) for recurrent, complex and bilateral inguinal hernias

Mahim Koshariya, Rakesh Pandey


Background: Managing complex inguinal hernia is always a challenge for surgeons. When recurrent or complex hernia is present it is mandatory to adopt an alternative and different approach for the repair of inguinal hernia to avoid any further complication and recurrence. Primary aim of this study is to assess the usefulness of Stoppa procedure in current situation for treatment of bilateral, complex and recurrent hernias.

Methods: A prospective and retrospective study of Stoppa procedure (giant prosthetic reinforcement of visceral sac [GPRVS]) for recurrent, complex and bilateral inguinal hernias was conducted in Department of General Surgery Hamidia Hospital from January 2016 to October 2017 , 30 patients with 27 bilateral and 3 unilateral hernias making total 57 hernial sites including five recurrent hernias (after Lichtenstein repair) were operated by GPRVS for bilateral, recurrent and complex inguinal hernias, were included in study.

Results: Four complications were seen. One patient developed seroma which resolved spontaneously, one patient developed superficial wound infection. One patient developed right testicular pain which was relieved after medication. One patient developed pain in groin and right thigh which was present preoperatively also but increased after surgery and was relieved on medication. Risk for recurrence present in 18 patients. No recurrence was observed.

Conclusions: Because of the excellent results, ease of the procedure and low complication rate, GPRVS is an effective and good option for bilateral, complex and recurrent inguinal hernias.


Complex inguinal hernia, Stoppa’s procedure (GPRVS)

Full Text:



Rutkow I. Epidemiologic, economic and sociologic aspects of hernia surgery in the united states in the 1990s. Surg Clin North Am. 1998;78;941-51.

Shuulman AG, Amid PK, Lichenstein IL. The plug repair of 1402 recurrent inguinal hernias 20-year experience. Arch Surg. 1990;125:265-7.

Abrahamson J. Hernias. In: Zinner MJ, ed. Manningot’s abdominal operations. 10th edition. Stamford: Appleton and Lange; 1997:479-580.

Stoppa R, Petit J, Henry X. Unsutured Dacron prosthesis in groin hernias. Int Surg. 1975;60(8):411-2.

Lowham A, Filipi C, Fitzgibbons R, Stoppa R, Wantz G, Felix E, et al. Mechanisms of hernia recurrence after preperitoneal mesh repair. Traditional and laparoscopic. Ann Surg. 1997;225 (4):422-31.

Beets G, Dirksen C, Go P, Geisler F, Baeten C, Kootstra G. Open or laparoscopic preperitoneal mesh repair for recurrent inguinal hernia? A randomized controlled trial. Surg Endosc. 1999;13 (4):323-7.

Stoppa R. The giant prosthesis for the reinforcement of visceral sac in the repair of groin and incisional hernias. In: Nyhus LM, Baker RJ, Fischer JE. (Eds). Mastery of surgery. 3rd ed. Boston: Little Brown; 1997:1859-1869.

Stoppa R. The preperitoneal approach and prosthetic repair of Groin hernias. In: Nyhus LM, Codon RE (eds): Hernia, 4th ed. Philadelphia: JB Lipincott; 1995:188-206.

Stoppa RE, Warloumont CR. The midline preperitoneal approach and the prosthetic repair of groin hernia. In: Nyhus LM, Baker RJ (eds): Mastery of surgery. 2nd ed. Boston: Little brown; 1992.

Stoppa RE, Rives JL, Warlaumont CR. The use of Dacron in repair of hernias in groin. Surg Clin North Am. 1984;64:269.

Mathonnet M, Cubertafond P, Gainant A. Bilateral inguinal hernias: giant prosthetic reinforcement of visceral sac. Hernia. 1997;1(2):93-6.

Champault G, Rizk N, Catheline JM. Hernias of the year. Preperitoneal laproscopic treatment versus stoppa surgery. Etude randomisee :100 cases. J Chir. 1966;133(6):274-80.

Salinier L. Comparative study of the treatment of inguinal herne by prosthesis. About 309 observations. These Med Bordeaux.1983;II(233).

Stoppa R, Houdard C. Surgical treatment of heroines of the elderly. Monograph of the French Association of Surgery. Paris: Masson; 1984:74.

Wanz GE. Personal experience with Stoppa technique. In: Nyhus LM, Condon RE (eds): Hernia 4th ed. Philadelphia J.B. Lippincott; 1995:206-210.

Rignault D, Dubois C, Andre H. Inguinal hernioplasty with prosthetic interposition. Surg. 1983;109(10):841.

Thapar VV, Rao PP, Prabhu RR, Desai CC, Singh AS, Supe AN. Giant prosthesis for reinforcement of visceral sac for complex, bilateral and recurrent Hernias: a prospective evaluation. J Postgrad Med. 2000;46(2):80.

Maghsoudi H, Pourzand A. Giant prosthetic reinforcement of the visceral sac: the Stoppa groin hernia repair in 234 patients. Ann Saudi Med. 2005;25(3):228-32.