How Long Does a Double Hernia Surgery Take?

A double hernia repair, most often meaning both sides of the groin are fixed in a single operation, typically takes between 60 and 110 minutes of actual operating time. That range shifts considerably depending on the surgical approach, whether the hernia is straightforward or complex, and the surgeon’s experience with the chosen technique. The time you spend in the operating room from start to finish will be longer than the surgical time alone, because anesthesia setup, positioning, and wake-up add their own minutes to the clock.

What “Double Hernia” Usually Means

When people say “double hernia,” they almost always mean bilateral inguinal hernias, where tissue pushes through a weak spot in the groin on both the left and the right side. Inguinal hernias are by far the most common type requiring surgery, and having them on both sides is not unusual. Less commonly, “double hernia” could refer to two hernias in different locations, such as one inguinal and one umbilical, but those are typically addressed as two separate procedures or staged repairs rather than a single “double” operation. The time estimates throughout this article refer to bilateral inguinal hernia repair performed in one session, since that is the scenario most people are asking about.

How Surgical Approach Changes Operating Time

The biggest single factor in how long your surgery takes is which technique the surgeon uses. There are three broad categories: open repair, laparoscopic repair, and robotic-assisted repair. Each has a different time profile, and for bilateral hernias, the differences become more pronounced because the surgeon is doing essentially double the work.

In open repair, the surgeon makes a separate incision on each side of the groin. For a single side, open inguinal hernia repair under local anesthesia can be quite fast. A large comparison study found that laparoscopic repair took only about four extra minutes compared with open repair under general anesthesia, and about ten extra minutes compared with open repair under local anesthesia.

Those numbers are for unilateral (one-sided) repair, though. For bilateral open repair, you are looking at roughly double the incision-to-closure time, because each side is essentially a standalone procedure. Laparoscopic and robotic approaches have a built-in advantage here: once the camera and instruments are inside the abdomen, the surgeon can access both groins through the same small incisions without repositioning or making new cuts. That efficiency gain means the second side typically adds less time than a full repeat of the first.

TEP Versus TAPP for Bilateral Repair

If your surgeon recommends a minimally invasive approach for bilateral inguinal hernia, the two main laparoscopic techniques are TEP (totally extraperitoneal) and TAPP (transabdominal preperitoneal). Both use small incisions and a camera, but they differ in where the surgeon works relative to the abdominal lining.

The evidence on which is faster is genuinely mixed. One study of bilateral repairs found a mean operative time of about 82 minutes for TEP and 107 minutes for TAPP.

Another study of bilateral cases found the opposite: TAPP averaged about 58 minutes while TEP averaged about 93 minutes.

A systematic review and meta-analysis pooling many studies found no statistically significant difference between the two techniques overall, with a mean difference of roughly nine minutes that could swing in either direction.

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The takeaway is that neither technique is consistently faster. What matters more is which one your surgeon has the most experience with, because proficiency with a specific approach has a larger impact on operative time than the inherent characteristics of the technique itself.

Where Robotic Surgery Fits In

Robotic-assisted hernia repair uses the same general principles as laparoscopic TAPP but adds a robotic platform that gives the surgeon more precise control of the instruments. The trade-off is setup time: docking the robot and placing the instruments adds roughly five minutes before the actual repair begins.

Most systematic reviews have concluded that robotic inguinal hernia repair takes longer than standard laparoscopic repair, with the added time ranging from about 14 to 33 minutes on average across published analyses. Two randomized trials found even larger gaps. The RIVAL trial reported a median of about 76 minutes for robotic repair versus 41 minutes for laparoscopic, and the VOLTAIRE trial found roughly 65 minutes versus 32 minutes.

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There is one notable exception. The DIRECT trial, conducted in Denmark, found that robotic TAPP was actually faster than laparoscopic TAPP: about 51 minutes versus 60 minutes for simple hernias, and about 72 versus 92 minutes for complex hernias including bilateral cases.

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Researchers suspect the DIRECT trial’s results reflect what happens when surgeons are already highly proficient with the robotic platform. In centers where the robot is newer or less frequently used, operative times tend to be longer. For bilateral repairs specifically, the robotic advantage may grow because the robot’s articulating wrists make the second side faster to dissect and mesh. But for now, in most surgical centers, you should expect robotic bilateral repair to take a bit longer than a comparable laparoscopic one.

What Adds Time to Any Double Hernia Repair

The 60-to-110-minute range assumes a planned, elective surgery on a reasonably healthy person. Several factors can push the time beyond that window:

Hernia complexity: A hernia that has slid into the scrotum (inguinoscrotal), one that has become incarcerated (stuck), or a recurrence after a previous repair all require more careful dissection. The DIRECT trial data showed that complex hernias took roughly 20 minutes longer than simple ones regardless of whether robotic or laparoscopic technique was used.
Body weight: Obesity makes the surgical field harder to visualize and the tissue planes more difficult to separate. A prospective study of abdominal wall hernia repairs found that obesity was independently associated with longer hospitalization, and surgeons widely report that it adds meaningful minutes to operative time.
Emergency presentation: If a hernia becomes strangulated (its blood supply is cut off), surgery cannot wait. Emergency inguinal hernia repairs take longer than elective ones. One study found a median operative time of 80 minutes for emergency repairs versus 65 minutes for planned ones.
Mesh fixation method: How the surgeon secures the mesh in place also matters. A study comparing two fixation methods during laparoscopic ventral hernia repair found that using absorbable tacks was about nine minutes faster than using a suturing technique.

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Surgeon experience is another big variable. Laparoscopic and robotic hernia repair both have learning curves that are well documented. A surgeon who has done hundreds of bilateral repairs will move through the steps more efficiently than one still climbing the curve. This effect is large enough that some studies showing robotic repair is “slower” may partly reflect that surgeons had less cumulative robotic experience than laparoscopic experience at the time the data were collected.

How Anesthesia Affects the Timeline

Most bilateral inguinal hernia repairs are done under general anesthesia, because the laparoscopic and robotic approaches require a relaxed abdominal wall and the ability to inflate the abdomen with gas. Open bilateral repair can sometimes be performed under regional (spinal) or even local anesthesia, though local anesthesia is more practical for single-sided repairs.

The type of anesthesia affects two clocks: the operative time itself and the recovery time afterward. A study of older patients found that using local rather than general anesthesia shaved a few minutes off the operation in patients under 75 and reduced the postoperative complication rate in those 75 and older.

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Spinal anesthesia, which numbs you from the waist down, avoids the grogginess of general anesthesia but comes with its own delays. A comparison of spinal versus local anesthesia for inguinal hernia repair found that patients who received local anesthesia recovered significantly faster and had fewer complications like low blood pressure and urinary retention.

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For most bilateral cases done laparoscopically or robotically, you will be under general anesthesia. Expect the anesthesia team to need 15 to 30 minutes before the surgery begins (for the IV, monitoring setup, intubation, and positioning) and another 15 to 30 minutes afterward as you wake up and are moved to recovery. Your total time from entering the operating suite to leaving the recovery area is often two to three hours longer than the operative time alone.

The Difference Between Operative Time and Your Total Time

When surgeons quote “how long the surgery takes,” they mean the time from the first incision (or first trocar insertion) to the last stitch or skin closure. That is the operative time. But as a patient, your experience is quite different. You arrive at the surgical center, change into a gown, have an IV placed, answer questions from the anesthesia team, get wheeled into the operating room, and only then does the actual clock start. Afterward, you go to a post-anesthesia care unit to wake up, get your pain under control, drink some fluids, and prove you can stand up and use the bathroom before being cleared to leave.

Research on outpatient surgery discharge times has found that the most common medical causes of delay are pain, drowsiness, and nausea or vomiting. But system-related factors cause even more holdups. In one study, lack of an available escort to drive the patient home accounted for over half of the system-related discharge delays.

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For a planned bilateral inguinal hernia repair, most people should budget about four to six hours from the time they walk through the door to the time they are cleared to leave. If you are having the surgery at a hospital rather than an ambulatory surgery center, some surgeons prefer an overnight stay, especially for patients with higher anesthetic risk or significant medical conditions. A prospective study found that factors like a higher anesthesia risk classification, surgery lasting more than 60 minutes, and the need for a surgical drain were all linked to longer hospital stays after hernia repair.

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Why Timing Matters for Emergency Cases

Everything discussed so far assumes a planned, elective repair. If a hernia becomes incarcerated or strangulated, the calculation changes dramatically. The hernia needs to be fixed quickly, and the surgery itself tends to be more complicated because the tissue is swollen, inflamed, or has lost blood supply.

Emergency hernia operations take longer on average. One study found that emergency cases had a median operative time of 80 minutes versus 65 minutes for elective repairs, along with longer hospital stays.

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Delaying emergency hernia surgery once you are in the hospital also worsens outcomes. An analysis of emergency hernia surgeries found that when surgery was delayed beyond the first day, the average operative time rose from about 88 minutes to over 100 minutes, the rate of major complications climbed, length of stay increased, and the risk of needing a second operation went up.

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The practical message here is straightforward: if you have been diagnosed with bilateral inguinal hernias and your surgeon recommends repair, getting it done electively is both faster and safer than waiting until one side becomes an emergency.

Double Hernia Surgery in Children

Bilateral inguinal hernias are common in pediatric patients, especially in premature infants and young boys. The surgery tends to be considerably shorter than in adults because the anatomy is smaller and the hernias are typically less complex. A study comparing laparoscopic and open repair in children found average operative times of about 25 minutes for laparoscopic and 31 minutes for open, with no significant difference between the two.

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Those figures are for unilateral repair, but pediatric bilateral repairs are still substantially faster than adult ones, often finishing in 30 to 45 minutes. The hernias in children are usually indirect hernias caused by a congenital opening that failed to close, and the repair involves closing that opening rather than placing a large mesh. Recovery is also faster, with most children going home the same day and returning to normal activity within a week or two.

How Mesh Fixation Adds or Saves Minutes

In nearly all adult hernia repairs, a synthetic mesh is placed to reinforce the weak area. How that mesh gets secured in position varies, and the choice has a measurable effect on how long the procedure takes. In laparoscopic repairs, common options include absorbable tacks, permanent tacks, fibrin glue, and suturing. A study of laparoscopic ventral hernia repair found that using a dual-crown tacking method cut about nine minutes off the average operative time compared with a trans-abdominal suture technique, reducing the mean from about 51 minutes to 41 minutes per case.

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For bilateral inguinal hernia repair, the effect roughly doubles because mesh must be placed on each side. If your surgeon uses a fixation technique that takes five to ten minutes longer per side, that can add 10 to 20 minutes to the total procedure. This is not something most patients get to choose, but it is worth understanding if your surgeon gives you a time estimate that seems longer than what you have read online. The difference may simply reflect their preferred fixation method, which they have chosen for durability or lower recurrence rates rather than speed.

What You Can Do to Keep Things on Schedule

You cannot control what happens once you are asleep on the table, but a few things within your power affect both the operative time and the overall experience. Losing weight before elective surgery, if you carry significant extra weight, reduces the technical difficulty and is associated with shorter procedures and fewer complications. Stopping smoking well ahead of surgery improves tissue healing and reduces the risk of surgical site infection, which is one of the factors linked to prolonged hospital stays.

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Arranging a reliable ride home before surgery day eliminates one of the most common non-medical causes of discharge delay. Asking your surgeon specifically what they mean by “how long the surgery takes” is also worthwhile, so you know whether they are quoting skin-to-skin operative time or the full door-to-door experience. And if you have a choice of surgeon, asking about their volume of bilateral hernia repairs is reasonable. Surgeons who perform the procedure frequently tend to be faster and have lower complication rates, which translates to shorter recovery and a smoother day overall.

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JAMA Surgery. Comparison of Postoperative Outcomes of Laparoscopic vs Open Inguinal Hernia Repair
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PubMed Central. Bilateral inguinal hernia repair by laparoscopic totally extraperitoneal (TEP) vs. laparoscopic transabdominal preperitoneal (TAPP)
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PubMed Central. Comparison of Clinical Outcomes of Laparoscopic Totally Extraperitoneal (TEP) and Transabdominal Preperitoneal (TAPP) Techniques in Bilateral Inguinal Hernia Repair: A Retrospective Study
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PubMed. Transabdominal preperitoneal (TAPP) versus totally extraperitoneal (TEP) repair for inguinal hernia: a systematic review and meta-analysis
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Laparoscopic, Endoscopic and Robotic Surgery. Robotic or laparoscopic inguinal hernia repair? A narrative review of the current literature
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PubMed Central. Shorter operative times following robotic-assisted transabdominal preperitoneal inguinal hernia repair (TAPP) compared to laparoscopic TAPP: the Danish Inguinal Randomized Controlled Trial (DIRECT)
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PubMed. Emergency vs. elective inguinal hernia repairs: early differences with similar long-term outcomes
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PubMed Central. Impact of the mesh fixation technique on operation time in laparoscopic repair of ventral hernias
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PubMed Central. Using Local Anesthesia for Inguinal Hernia Repair Reduces Complications in Older Patients
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European Journal of Cardiovascular Medicine. Comparison of Spinal Anesthesia versus Local Anesthesia for Inguinal Hernia repair
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Anesthesia & Analgesia. Factors Affecting Discharge Time in Adult Outpatients
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PubMed Central. Factors predicting prolonged hospitalization after abdominal wall hernia repair – a prospective observational study
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PubMed Central. Delay in Emergency Hernia Surgery is Associated with Worse Outcomes
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PubMed Central. Pediatric Inguinal Hernia: Laparoscopic Versus Open Surgery