{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T22:05:31Z","timestamp":1770415531993,"version":"3.49.0"},"reference-count":29,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The concurrent management of cholelithiasis and inguinal hernia remains a subject of surgical debate, primarily due to concerns regarding prosthetic mesh infection in a clean-contaminated field. This study evaluates the safety, cost-effectiveness, and functional outcomes of simultaneous totally extraperitoneal (TEP) repair and laparoscopic cholecystectomy (LC). Materials and Methods: A retrospective analysis was conducted on patients treated between 2015 and 2025 using a prospectively maintained institutional registry. The cohort was stratified into two arms: the Simultaneous Group (n = 16), undergoing synchronous TEP and LC; and the Staged Group (n = 13), managed via separate sessions. A strict \u201chernia-first\u201d operative sequence was enforced to maintain sterility. Key endpoints included perioperative morbidity, long-term recurrence (mean follow-up: 53.9 months), economic burden, and quality of life (EuraHS-QoL). Results: No surgical site or prosthetic infections were documented in either cohort. The Simultaneous arm demonstrated a significantly reduced total operative duration compared to the cumulative time of the Staged approach (164.6 \u00b1 44.9 vs. 226.2 \u00b1 57.4 min; p = 0.003) and yielded a shorter hospitalization period (1.44 \u00b1 0.51 vs. 2.31 \u00b1 0.85 days; p = 0.002). Workforce reintegration was markedly accelerated in the simultaneous group (9.43 \u00b1 3.36 vs. 24.69 \u00b1 12.35 days; p &lt; 0.001), translating to a total cost reduction of approximately 51% for unilateral cases. Conclusions: Concomitant TEP and LC represents a clinically viable and financially prudent strategy that does not compromise patient safety or prosthetic durability. Adherence to a strict \u201chernia-first\u201d surgical sequence appears critical to preventing infectious morbidity. Given the superior resource utilization, this dual approach merits consideration as a primary therapeutic algorithm.<\/jats:p>","DOI":"10.3390\/medicina62020330","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T10:05:47Z","timestamp":1770372347000},"page":"330","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Simultaneous TEP Inguinal Hernia Repair and Laparoscopic Cholecystectomy: A Retrospective Analysis of Safety, Cost-Effectiveness, and Outcomes"],"prefix":"10.3390","volume":"62","author":[{"given":"Zekai Serhan","family":"Derici","sequence":"first","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, Dokuz Eylul University, 35340 Balcova, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4755-2200","authenticated-orcid":false,"given":"Berke","family":"Mano\u011flu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, Dokuz Eylul University, 35340 Balcova, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tayfun","family":"Bi\u015fgin","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, Dokuz Eylul University, 35340 Balcova, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9848-0326","authenticated-orcid":false,"given":"Cihan","family":"A\u011falar","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, Dokuz Eylul University, 35340 Balcova, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2293-6050","authenticated-orcid":false,"given":"Mert","family":"Kazanc\u0131","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, Dokuz Eylul University, 35340 Balcova, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1834-8630","authenticated-orcid":false,"given":"Tufan","family":"Egeli","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, Dokuz Eylul University, 35340 Balcova, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2217-6819","authenticated-orcid":false,"given":"S\u00fcleyman \u00d6zkan","family":"Aksoy","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, Dokuz Eylul University, 35340 Balcova, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Francesco, F., Mola, D., Huerta, S., and Garza, A.M. 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Genel T\u0131p Derg."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/2\/330\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T10:41:07Z","timestamp":1770374467000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/2\/330"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,6]]},"references-count":29,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["medicina62020330"],"URL":"https:\/\/doi.org\/10.3390\/medicina62020330","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,6]]}}}