Prospective randomized study comparing single-incision laparoscopic versus multi-trocar laparoscopic totally extraperitoneal (TEP) inguinal hernia repair at 2 years

Cardinali, Luca; Mazzetti, Claudia Hannele; Febres, Anny Cadenas; Repullo, Deborah; Bruyns, Jean Andre; Dapri, Giovanni

doi:10.1007/s00464-018-6045-z

Cited by 21 publications

(36 citation statements)

References 27 publications

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“…Further development of laparoscopic surgery technique focused on decreasing the number of incisions in single incision laparoscopic surgery, which is also used in hernia operations. Available scientific evidence does not demonstrate a clear clinical advantage of single incision laparoscopic surgery used in hernia repair over traditional laparoscopic surgery in terms of length of hospital stay, operative time, pain, recurrence, post-operative complications, issues related to ergonomics, surgical learning curve, and equipment needs [15][16][17][18][30][31][32]. Our study tries to join in the discussion about advantages of TEP-SI over TEP by revealing the differences in oxidative stress levels between two types of surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Lately, single incision technique (TEP-SI) is growing in popularity in hernia operations [13,14]. A number of studies comparing single-incision laparoscopic totally extra-peritoneal inguinal hernia repair with standard TEP procedure have been published in recent years [15][16][17][18]. However, they did not prove a significant advantage of TEP-SI over TEP.…”

Section: Introductionmentioning

confidence: 99%

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A comparison of the oxidative stress response in single-incision laparoscopic versus multi-trocar laparoscopic totally extraperitoneal inguinal hernia repair.

Białecki¹,

Myszka

Wysocka

et al. 2020

Videosurgery and Other Miniinvasive Techniques

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Introduction Surgical treatment is always associated with tissue damage and the subsequent development of oxidative stress. Aim To compare the oxidative stress response in patients treated operatively for inguinal hernia with multi-trocar laparoscopic totally extraperitoneal technique (TEP) or single-incision laparoscopic totally extraperitoneal technique (TEP-SI). Material and methods A randomized group of 34 patients with one-sided inguinal hernia was enrolled in the study. Seventeen patients were treated with a standard TEP method (group 1) and the other 17 patients were treated with the TEP-SI technique (group 2). Thiobarbituric acid reactive substances (TBARS) and total antioxidant status (TAS) as the oxidative stress markers were measured before surgery (0), 1 day (1) and 4 days (2) after surgery. Results A decrease in TAS on the first day after surgery was observed in both groups. Sustained reduction on the fourth day after surgery was observed in group 1, whereas in group 2 an increase followed. A statistically significant difference was observed in TAS (2 : 0) ratio with a meaningful decrease in group 1. TBARS concentration was elevated 1 day after surgery in both groups. It remained at an elevated level on the fourth day after surgery in group 1, while it decreased in group 2. The duration of surgery was higher in group 2 (mean: 57.5 min) than in group 1 (mean: 50.0 min) (p = 0.0286). Conclusions Oxidative stress levels are lower in patients treated operatively by TEP-SI technique than by TEP. TEP-SI may be considered as a less invasive technique associated with less tissue injury.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A comparison of the oxidative stress response in single-incision laparoscopic versus multi-trocar laparoscopic totally extraperitoneal inguinal hernia repair.

Białecki¹,

Myszka

Wysocka

et al. 2020

Videosurgery and Other Miniinvasive Techniques

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“…The overall postoperative morbidity rate was significantly lower in the NS group, but only with the multiport TEP method ( P = 0·004). Experience with single‐port TEP in patients with previous abdominal surgery remains limited.…”

Section: Discussionmentioning

confidence: 99%

Meta-analysis of totally extraperitoneal inguinal hernia repair in patients with previous lower abdominal surgery

Prassas

Rolfs²,

Knoefel

et al. 2019

British Journal of Surgery

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Background: Previous lower abdominal surgery is considered a relative contraindication to laparoscopic totally extraperitoneal (TEP) inguinal hernia repair. This was a meta-analysis of studies comparing the feasibility and safety of TEP repair between patients with (PS), and without (NS) a history of lower abdominal surgery. Methods: A systematic literature search was undertaken for studies comparing the outcome of TEP inguinal hernia repair in patients with, and without previous lower abdominal surgery. Data on postoperative outcomes were extracted and compared by meta-analysis. Odds ratios (ORs) and mean differences with 95 per cent confidence intervals were calculated.Results: Seven comparative cohort studies were identified, involving a total of 1657 procedures (PS 326, NS 1331). There was a statistically significant difference between PS and NS favouring the NS group with regard to both primary outcomes: intraoperative morbidity (OR 2⋅85, 95 per cent c.i. 1⋅19 to 6⋅80; P = 0⋅02; 7 studies; I 2 = 33 per cent), and postoperative morbidity in the multiport subgroup (OR 2⋅14, 1⋅28 to 3⋅58; P = 0⋅004; 5 studies; I 2 = 0 per cent). For the secondary endpoints conversion rate, peritoneal tears, major intraoperative bleeding, postoperative haematoseroma and delay in return to normal activities, there was a statistically significant difference favouring the NS group.Conclusion: This study suggests that patients with previous lower abdominal surgery who need hernia repair get less benefit from TEP repair than those with no history of surgery.

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“…For the potential benefits of SIL-TEP in terms of cosmesis, pain reduction and recovery speed, the surgical technique has become increasingly popular. [6][7][8] Recent years, numbers of studies comparing SIL-TEP with conventional TEP have been published. [6][7][8] Their results verified the SIL-TEP is a feasible and safe surgical procedure.…”

Section: Introductionmentioning

confidence: 99%

Single incision laparoscopic totally preperitoneal hernioplasty (SIL-TPP): Lessons learned from 102 procedures and initial experience

Zhou

Wang

et al. 2022

Medicine

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Background: The abdominal wall in groin area is conventionally considered that it was comprised by 9 layers. Single incision laparoscopy totally extraperitoneal hernioplasty (SIL-TEP) reported before were operated through the front of the posterior rectus sheath. Method: 102 SIL-TPP were conducted from October 2018 to October 2020 at The Affiliated Hospital of Medical School of Ningbo University using a self-made single-port device and standard laparoscopic instruments. Clinical data, demographic and intraoperative findings, and short-term postoperative outcomes were analyzed. Results: Of the 102 hernias treated, 46 were right inguinal hernias, 33 were left inguinal hernias and 23 were double-side inguinal hernias. All patients received the SIL-TPP and no conversion happened. The mean left-side and right-side hernia operative time was almost same. The left-side and right-side operative time were 75.48 ± 26.95 and 76.24 ± 26.09 minutes, respectively. The mean operative time was 75.92 ± 26.45 (range, 29–170 minutes) in unilateral inguinal hernia. Mean operative time was 104.17 ± 28.58 minutes (range, 67–180 minutes) in double-side inguinal hernia. The intraoperative complications rate was 21.57 (22/102) and all the complications were Peritoneum or sac tearing. Postoperative complications occurred in 3 cases (1 case wound seroma, 1 case urinary retension and 1 case upper respiratory infection) and were successfully treated conservatively. The mean hospital stay was 2.8646 ± 1.38 days. The 24 hours Visual analogue scale score was 2.28 ± 0.77. During follow-up to June 2022, no recurrence case occurred. Conclusion: SIL-TPP is safe and feasible. SIL-TPP has its unique skills and advantages to treat inguinal hernia. Large-scale randomized controlled trials comparing SIL-TPP inguinal hernia repair with conventional single port and conventional three port laparoscopic totally extraperitoneal hernioplasty with short-term outcome and long-term recurrence rate are needed to confirm these results.

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Prospective randomized study comparing single-incision laparoscopic versus multi-trocar laparoscopic totally extraperitoneal (TEP) inguinal hernia repair at 2 years

Abstract: Perioperative, short-term, and mid-term outcomes were comparable between the two groups. At 2-year follow-up, a significant shorter operative time after MTLTEP and a greater cosmetic satisfaction after SILTEP have been found.

Cited by 21 publications

References 27 publications

A comparison of the oxidative stress response in single-incision laparoscopic versus multi-trocar laparoscopic totally extraperitoneal inguinal hernia repair.

A comparison of the oxidative stress response in single-incision laparoscopic versus multi-trocar laparoscopic totally extraperitoneal inguinal hernia repair.

Meta-analysis of totally extraperitoneal inguinal hernia repair in patients with previous lower abdominal surgery

Single incision laparoscopic totally preperitoneal hernioplasty (SIL-TPP): Lessons learned from 102 procedures and initial experience

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