Single incision approach to totally extraperitoneal inguinal hernia repair.

Abstract

IntroductionNowadays the vast majority of inguinal hernia repairs are laparoscopically assisted. Single incision laparoscopy aims to accelerate recovery and provide a better cosmetic outcome after the operation.AimTo present our own modification of the totally extraperitoneal (TEP) procedure with a single incision and without a multiport, and compare the results with those obtained in the classic three-trocar TEP method.Material and methodsThe study group comprised 61 males. The first group consisted of 35 males who underwent single incision videoscopic alloplasty TEP. The second group comprised 26 males who underwent videoscopic alloplasty using the classic approach. The study assessed the time of operation, complications and postoperative pain based on the VAPS scale.ResultsThe operation time in the first group was statistically longer compared with the time in the second group. The assessment of differences in postoperative pain in both the examined groups on the first and seventh day after the operation was considered statistically insignificant. In both the studied groups there was no recurrence of hernia established on the first and seventh day after the operation.ConclusionsThe reduced number of incisions in the TEP method with a single incision approach without a multiport involves a decrease in the number of postoperative scars, and thus offers a better cosmetic outcome compared with the classic TEP procedure. The time of TEP operation performed with a single incision approach without a multiport is statistically longer than the duration of the classic laparoscopic TEP procedure.

The management of abdominal wall hernias - in search of consensus.

“…It gives trainees the opportunity to see many experienced surgeons at work and to learn from them. This allows them to obtain knowledge about various surgical techniques and gain the ability to think multidimensionally [ 17 – 20 ]. Smietanski, in his article “The influence of carrying out multicentre trials on surgical practice in general surgery departments”, showed that only exchange of knowledge and internships in different units, from district to university hospitals, can improve the training of young surgeons [ 21 ].…”

New minimally invasive technique of parastomal hernia repair - methods and review.

“…Laparoscopic technique has gained in popularity because it combines the advantages of minimally invasive technique and mesh usage [ 29 ]. The main advantages of this technique is minimization of postoperative pain, shortening the period of convalescence, reducing the wound complications and others connected with laparotomy [ 30 , 31 ]. In parastomal hernia surgery laparoscopy allows for minimization of the postoperative wound and complications associated with it.…”

Laparoendoscopic single‐site surgery in inguinal hernia repair

“…The 2014 study by Lai et al incorporated eight clinical trials—two on percutaneous extraperitoneal closure (PEC) , one on TAPP , and five on TEP —in its quantitative analysis; the eight trials had a total of 926 patients . A study by Luo et al published in 2017 included 17 clinical trials—2 on PEC , 2 on TAPP , and 13 on TEP —in its quantitative analysis; the 17 trials had a total of 1737 patients . The 2016 study by Sajid et al incorporated 15 trials—2 on PEC , 1 on TAPP , 11 on TEP , and 1 with combined results from TAPP and TEP —in its quantitative analysis; the 15 trials had a total of 1651 patients .…”

“…The 2014 study by Siddiqui et al included three studies that analyzed a total of 287 patients (LESS, 128; conventional, 159) . The 2016 study by Lo et al included seven additional studies, for a total of 10, in its quantitative analysis ; these studies included four RCT, three prospective studies, and three retrospective studies, with a total of 1109 patients (LESS TEP, 595; conventional TEP, 514). The study by Lo et al found unilateral LESS TEP took significantly longer than conventional TEP ( P = 0.02); there was no significant heterogeneity of data from the studies used.…”