A Comparative Analysis of Single Umbilical Tangential Incision vs. Conventional Three-port Totally Extraperitoneal Inguinal Hernia Repair

Abstract

Purpose:We have explored the question of what benefits SUTI-TEP can provide over conventional three-port TEP (C-TEP) surgery for the treatment of inguinal hernia. Methods:One hundred forty cases (70 SUTI-TEP and 70 C-TEP) were reviewed in this study. SUTI-TEP procedure was carried out with SILS TM port as we reported before. Patient demographics and perioperative outcomes of SUTI-TEP were analyzed and compared with those of C-TEP.Results: There was no conversion to open surgery or C-TEP in SUTI-TEP group. Median VAS immediate postoperatively was slightly higher in SUTI-TEP group, but it was statistically significant. POD 7 th day pain after surgery were similar in both groups. Regarding the length of operation time, SUTI-TEP group (71.2 min) was significantly longer than that of the C-TEP group (41 min) (p＜0.001). There was no major morbidity or mortality postoperatively in either group. There was also no recurrence or chronic pain during follow up. Patient overall satisfaction including cosmetic outcome was excellent in SUTI-TEP group. Conclusion:Although the longer operation time tends to be required, SUTI-TEP can provide better cosmesis and patient satisfaction, and also safety. That may be good indicator of the success of after surgery. Also we should not presume that one large incision causes less pain than small multiple incision because it is just single one. If there is more pain in one single wound, we should find the solution through the innovation of technology or preventive measures.