Single-incision laparoscopic totally extraperitoneal inguinal hernia repair with tumescent local anesthesia: report of more than 2000 procedures at a day-surgery clinic

Wakasugi, Masaki; Hasegawa, Junichi; Ikeda, Yoshihiro

doi:10.1007/s00595-020-02141-0

Cited by 4 publications

(4 citation statements)

References 8 publications

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“…Besides, there was no case need to convert to other procedures and reoperate. Consequence, it is believed the safety and short-term outcome of SIL-TPP and SIL-TEP in our study was comparable when compared to previous SIL-TEP and conventional TEP study [ 5 , 8 , 9 , 14 , 15 ].…”

Section: Discussionsupporting

confidence: 72%

“…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%

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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: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

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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“…Previous studies have reported the reoperation morbidity was 5.7% to 15.8% in SIL-TEP and 3.2% to 14% in CL-TEP studies. [20,22,25–27] Consequently, the morbidity rate of this study was comparable. In our study, there were one seroma, one hydrocele of testes and one suffered upper respiratory infection.…”

Section: Discussionmentioning

confidence: 61%

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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“…Compared with conventional laparoscopic inguinal hernia repair, SIL-IHR has the potential benefits of faster postoperative recovery, less pain, and better cosmetic outcomes for patients while maintaining the advantages of a posterior approach. Due to these potential advantages, there have been numerous reports about SIL-IHR to date, suggesting that it has similar short-and longterm outcomes to conventional multi-incision laparoscopic inguinal hernia repair [4][5][6]. However, most reported cases were very limited in number [7] and focused on SIL-TEP, while short-and long-term outcomes of SIL-TAPP at large single institutions were rarely reported.…”

Section: Introductionmentioning

confidence: 99%

Single-incision laparoscopic transabdominal preperitoneal hernioplasty: 1,054 procedures and experience

Jiao

Zhu

Zhou

et al. 2023

Hernia

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Purpose Although there have been numerous studies on single-incision laparoscopic inguinal hernia repair (SIL-IHR), the short- and long-term outcomes in patients from a large single institution who underwent single-incision laparoscopic transabdominal preperitoneal hernioplasty (SIL-TAPP) have rarely been reported. The purpose of this study is to evaluate the short- and long-term outcomes of SIL-TAPP and its safety and feasibility in patients from a large single institution. Methods The details of 1,054 procedures in 966 patients who underwent SIL-TAPP at the Affiliated Hospital of Nantong University from January 2015 to October 2022 were retrospectively analysed. SIL-TAPP was performed completely through the umbilicus using conventional laparoscopic instruments. Short-term and long-term outcomes of SIL-TAPP were collected by outpatient and telephone follow-ups. In addition, we further compared the operation time, length of postoperative hospital stay, and postoperative complications of patients with simple and complicated unilateral inguinal hernias. Results A total of 1,054 procedures were performed for 878 unilateral inguinal hernias and 88 bilateral inguinal hernias. In total, there were 803 (76.2%) indirect inguinal hernias, 192 (18.2%) direct inguinal hernias, 51 (4.8%) femoral hernias and 8 (0.8%) combined hernias. The mean operative time was 35.5 ± 17.0 min for unilateral inguinal hernias and 51.9 ± 25.5 min for bilateral inguinal hernias. There was one (0.1%) conversion to two-incision laparoscopic transabdominal preperitoneal hernioplasty. No intraoperative haemorrhages, inferior epigastric vessel injury or nerve damage occurred. Postoperative complications were minor and could be resolved without surgical intervention. The mean length of hospital stay was 1.3 ± 0.8 days. The median follow-up was 44 months, no trocar hernia occurred, and there was one (0.1%) recurrence. The operation time in the complicated inguinal hernia group was significantly higher than that in the simple inguinal hernia group (38.9 ± 22.3 vs. 35.0 ± 15.6, p = 0.025). The length of postoperative hospital stay and complication rate of the complicated inguinal hernia group were slightly higher than those of the simple inguinal hernia group, but the difference was not statistically significant. Conclusion SIL-TAPP is safe and technically feasible, and both short- and long-term outcomes are acceptable.

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Single-incision laparoscopic totally extraperitoneal inguinal hernia repair with tumescent local anesthesia: report of more than 2000 procedures at a day-surgery clinic

Cited by 4 publications

References 8 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)

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

Single-incision laparoscopic transabdominal preperitoneal hernioplasty: 1,054 procedures and experience

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