Long-term outcomes of single-incision versus multiport laparoscopic totally extra-peritoneal inguinal hernia repair: a single-institution experience of 186 consecutive cases

Suzuki, Yozo; Wakasugi, Masaki; Mikamori, Manabu; Tamaoka, Kohei; Nakahara, Yujiro; Tei, Mitsuyoshi; Furukawa, Katsunori; Ohtsuka, Masahisa; Masuzawa, Toru; Akamatsu, Hiroki

doi:10.1007/s00595-021-02323-4

Cited by 5 publications

(5 citation statements)

References 33 publications

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“…Single-incision laparoscopy (SIL) has attracted interest in the past decade, mainly because it improves cosmetic outcomes and reduces trauma [ 7 ]. Besides, the safety and efficacy of SIL–TEP for inguinal hernia repair had been verified in a serious of studies [ 3 – 5 , 8 , 9 ]. It is regretful that almost all SIL-TEP procedure reported before were operated through the space between the front of the posterior sheath and rectus abdominis and then enter the PPS for repairing inguinal hernia.…”

Section: Discussionmentioning

confidence: 99%

“…Although SIL-TEP owe its difficulties, such as confined operating space, in-line positioning of laparoscope, instruments confliction and so on [ 16 ], evidence suggested the mean operative time for unilateral hernia in SIL-TEP was comparable to previous CL TEP studies for experienced surgeon who have overcame the learning period [ 14 , 17 ]. In addition, selection bias for surgical candidates is also a significant factor affecting the operating time [ 3 , 12 , 18 ]. Though our initial 52 cases mean operating time of SIL-TEP in study is longer than some previous study only operated for primary male inguinal hernia patients or operated by experienced surgeon [ 5 , 13 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…Since the first single incision laparoscopy totally extraperitoneal hernioplasty (SIL-TEP) reported by Filipovic-Cugura et al in 2009 [ 2 ], the surgical technique has become increasingly popular for its benefits, such as cosmesis, pain reduction and rapid recovery. Furthermore, many evidence have proved the feasibility and safety of the procedure [ 3 – 5 ]. The most significant difference is TEP procedure prevents entering the peritoneal cavity, but it involves limited working space, visual field and instruments collision.…”

Section: Introductionmentioning

confidence: 99%

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TPP (totally preperitoneal) making single incision laparoscopic inguinal hernia repair more feasible: a comparison with single incision laparoscopic totally extraperitoneal hernioplasty (SIL-TEP)

Huang,

Wang,

Xiang

et al. 2024

BMC Surg

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Background Totally preperitoneal hernioplasty (TPP) is a concept which was introduced for distinguishing with totally extraperitoneal (TEP). There is few evidence reflecting the single incision laparoscopic totally preperitoneal (SIL-TPP) characteristic. The aim of study is to demonstrate the feasibility of single incision laparoscopic totally preperitoneal hernioplasty (SIL-TPP) and compare the outcomes with the single incision laparoscopic totally extraperitoneal hernioplasty (SIL-TEP) technique. Methods During August 2018 and July 2022, 200 inguinal hernia patients received SIL-TPP and 56 patients received SIL-TEP in the First hospital of Ningbo university. The demographics, clinical characteristics, intraoperative and postoperative parameters were retrospectively analysed. Results SIL-TPP and SIL-TEP hernia repair were successfully conducted in all patients. There was no conversation happened in two group. Patients’ demographics were comparable when compared between the two groups adding the comparison initial 52 cases analysis (P > 0.05). The mean unilateral hernia operative time was significant shorter in the SIL-TPP group than SIL-TEP group (unilateral: 81.38 ± 25.32 vs. 95.96 ± 28.54, P: 0.001). Further study of unilateral hernia operative time revealed the mean indirect hernia operative time was significant shorter in the SIL-TPP group than SIL-TEP group (indirect: 81.38 ± 25.33 vs. 95.87 ± 28.54, P: 0.001). The unilateral hernia operation time trend of initial 52 cases of two group analysis revealed the operation time of SIL-TPP reduced faster than SIL-TEP along with treating number increasing (Figs. 2 and 3). The comparison of initial equal quantity unilateral hernia patient mean operative time revealed the SIL-TPP group was significant shorter than SIL-TEP group (85.77 ± 22.76 vs. 95.87 ± 28.54, P: 0.049). The rate of peritoneum tearing of SIL-TPP group was significant high than SIL-TEP (P = 0.005). Conclusion SIL-TPP hernia repair is a superior procedure and possess its own distinguished advantages. We recommend it rather than SIL-TEP for treating inguinal hernia, especially for indirect hernia. However, large-scale randomized controlled trials comparing SIL-TPP and SIL-TEP are needed to confirm these results.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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TPP (totally preperitoneal) making single incision laparoscopic inguinal hernia repair more feasible: a comparison with single incision laparoscopic totally extraperitoneal hernioplasty (SIL-TEP)

Huang,

Wang,

Xiang

et al. 2024

BMC Surg

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“…[51] SILS conceals the surgical incision in the umbilicus or at the umbilical margin, resulting in less pain, faster recovery, no significant difference in complications, and good cosmetic results; this method is safe and effective compared with conventional three-port laparoscopic hernia repair, with the disadvantage that SIL-TAPP repair may require a longer operation, as the procedure is more difficult and has a steeper learning curve. [52,53] SILS-TEP repair is also applicable to patients with a previous history of open hernia repair and elderly patients. [54][55][56]…”

Section: Single-incision Laparoscopic Surgery (Sils): An Innovative L...mentioning

confidence: 99%

Current status and progress of laparoscopic inguinal hernia repair: A review

Wang

et al. 2023

Medicine

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After 30 years of development, laparoscopic inguinal hernia repair (LIHR) has become the main method for treating adult inguinal hernia. LIHR is more standardized, the approach of single-port laparoscopic hernioplasty, the advantages of robotic inguinal hernioplasty, the application of new patches and the selection of surgical methods for different populations have become the focus and difficulty of current research. This article summarized the research progress of LIHR in recent years. Different keywords and phrases including inguinal hernia, LIHR, transabdominal laparoscopic preperitoneal hernia repair, and total extraperitoneal hernia repair were used to search the PubMed, China National Knowledge Infrastructure, and Web of Science databases for related original and review articles that serve the aim of this article well, which was to perform a nonsystematic review of the development, progress, and current status of LIHR.

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“…Since Cugura et al [ 3 ] firstly reported single-incision laparoscopic totally extraperitoneal hernioplasty (SIL-TEP) with a case report in 2008, much evidence has revealed the safety and feasibility of this operation[ 4 , 5 ]. However, evidence also suggests that SIL-TEP has inherent disadvantages, such as limited operation space, in-line positioning of the laparoscope, and instrument conflict, among others, which cannot be overcome through improved surgical skills[ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Potential applications of single-incision laparoscopic totally preperitoneal hernioplasty

Wang,

Fei,

Xiang

et al. 2024

World J Gastrointest Surg

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BACKGROUND The totally preperitoneal (TPP) approach is a new concept that was recently introduced. Although the TPP approach combined with single-incision laparoscopic hernia repair has its own advantages, there is little evidence reflecting the characteristics and feasibility of either approach. AIM To analyze the potential applications of single-incision laparoscopic TPP (SIL-TPP) inguinal hernia hernioplasty for the treatment of inguinal hernias. METHODS A total of 152 SIL-TPP surgeries were performed at the First Affiliated Hospital of Ningbo University from February 2019 to November 2022. A single-port, named Iconport, and standard laparoscopic instruments were used during the operation. Demographic data, intraoperative parameters and short-term postoperative outcomes were collected and retrospectively analyzed. RESULTS The demographic data of 152 patients underwent SIL-TPP were shown in Table 1 . The average age was 49.5 years (range from 21 to 81 years). The average body mass index was 27.7 kg/m2 (range from 17.7 kg/m2 to 35.6 kg/m2). SIL-TPP were conducted successfully in 147 patients. Three patients were converted to the SIL-transabdominal preperitoneal laparoscopic herniorrhaphy at the initial stage of the study due to a lack of experience. In 2 patients with incisional hernias, an auxiliary operation hole was added during the SIL-TPP procedure, as required for surgery. The mean operative time was 64.5 minutes (range: 36.0-110.0 minutes) for unilateral direct and femoral hernias and 81.6 minutes for indirect hernias (range: 40.0-150.0 minutes). The mean postoperative hospital stay was 3.4 days. CONCLUSION SIL-TPP is feasible and has advantages for inguinal hernia repair. SIL-TPP has potential benefits for patients with various abdominal wall hernias. Consequently, doctors should be encouraged to actively apply the TPP approach combined with a single incision in their daily work.

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Long-term outcomes of single-incision versus multiport laparoscopic totally extra-peritoneal inguinal hernia repair: a single-institution experience of 186 consecutive cases

Cited by 5 publications

References 33 publications

TPP (totally preperitoneal) making single incision laparoscopic inguinal hernia repair more feasible: a comparison with single incision laparoscopic totally extraperitoneal hernioplasty (SIL-TEP)

TPP (totally preperitoneal) making single incision laparoscopic inguinal hernia repair more feasible: a comparison with single incision laparoscopic totally extraperitoneal hernioplasty (SIL-TEP)

Current status and progress of laparoscopic inguinal hernia repair: A review

Potential applications of single-incision laparoscopic totally preperitoneal hernioplasty

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