Ann Surg Treat Res.  2021 Jan;100(1):47-53. 10.4174/astr.2021.100.1.47.

Single incision laparoscopic totally extraperitoneal hernioplasty: lessons learned from 1,231 procedures

• Lee YJ
• Kim JH
• Kim CH
• Lee GR
• Lee YS
• Kim HJ

• KMID: 2510043
• DOI: http://doi.org/10.4174/astr.2021.100.1.47

Abstract

Purpose
Although there are many articles about single incision laparoscopic (SIL) hernioplasty, a large-scale study or article about its long-term outcome has not been reported yet. The aim of this study is to assess short- and long-term outcomes of SIL totally extraperitoneal (TEP) hernia repair with large number of cases.
Methods
A prospectively collected database containing details of 1,231 procedures in 1,129 consecutive patients who underwent SIL-TEP hernia repair between June 2010 and December 2017 at a single institution was retrospectively analyzed. SIL-TEP hernia repair was performed using a glove single port device and standard laparoscopic instruments. Recurrence rate of SIL-TEP hernia repair was analyzed by a telephone questionnaire.
Results
Among 1,129 patients, 1,027 (91.0%) had unilateral hernia and 102 (9.0%) had bilateral hernia. There were 12 (1.1%) conversions to single or 3 ports laparoscopic transabdominal preperitoneal hernioplasty or Lichtenstein repair. Mean operative time was 40.3 minutes for unilateral hernia and 61.6 minutes for bilateral hernia. Intraoperative complication rate was 21.8%. Most intraoperative complications were peritoneum or sac tearing (20.1%). Postoperative complications occurred in 97 (8.6%) cases, most of which were minor morbidity except for 1 mesh infection. Five-year recurrence rate was 4%.
Conclusion
SIL-TEP hernia repair is safe and technically feasible with acceptable short- and long-term outcomes. Largescale randomized controlled trials comparing SIL-TEP hernia repair with conventional laparoscopic TEP are needed to confirm these results.

Keyword

Inguinal hernia; Laparoscopy