J Korean Surg Soc.  2011 Nov;81(5):339-343. 10.4174/jkss.2011.81.5.339.

Initial experience of single port laparoscopic totally extraperitoneal hernia repair: nearly-scarless inguinal hernia repair

• Kim JH
• Park SM
• Kim JJ
• Lee YS

• KMID: 2096688
• DOI: http://doi.org/10.4174/jkss.2011.81.5.339

Abstract

PURPOSE
In the early 1990's laparoscopic hernioplasty gained popularity worldwide. Thereafter, laparoscopic surgeons have attempted to improve cosmesis using single port surgery. This study aims to introduce and assess the safety and feasibility of single port laparoscopic total extraperitoneal (TEP) hernia repair with a nearly-scarless umbilical incision.
METHODS
Sixty three single port laparoscopic TEP hernia repairs were performed in sixty patients from June 2010 to March 2011 at Incheon St. Mary's Hospital, with the use of a glove single-port device and standard laparoscopic instruments. Demographic and clinical data, intraoperative findings, and postoperative course were reviewed.
RESULTS
Of the 63 hernias treated, 31 were right inguinal hernias, 26 were left inguinal hernias and 3 were both inguinal hernias. There was one conversion to conventional three port laparoscopic transabdominal preperitoneal hernioplasty. Mean operative time was 62 minutes (range, 32 to 150 minutes). There were no intraoperative complications. Postoperative complications occurred in two cases (wound seroma and urinary retension) and were successfully treated conservatively. Mean hospital stay was 2.15 days.
CONCLUSION
Single port laparoscopic TEP hernia repair is safe and feasible. Umbilical incision provides an excellent cosmetic outcome. Prospective randomized studies comparing single port and conventional three port laparoscopic TEP repairs with short-term outcome and long-term recurrence rate are needed for confirmation.

Keyword

Single port; SILS; LESS; TEP; Inguinal hernia

MeSH Terms

Cosmetics
Hernia
Hernia, Inguinal
Herniorrhaphy
Humans
Intraoperative Complications
Length of Stay
Operative Time
Postoperative Complications
Pyrazines
Recurrence
Seroma
Cosmetics
Pyrazines

Figure

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  Fig. 1 Appearance of wound retractor placed in incision. Ruler indicates 2 cm diameter of incision. Retractor was ALEXIS XS (Applied Medical Resources Co., Rancho Santa Margarita, CA, USA).

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  Fig. 2 Photograph of glove single port, which was composed of wound retractor and surgical glove.

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  Fig. 3 Sac dissection was performed by spread technique.

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  Fig. 4 Completion of sac isolation.

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  Fig. 5 Scar of single port total extraperitoneal hernioplasty at post-operation.

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