Single-Port Laparoscopic Total Extraperitoneal Inguinal Hernia Repair without Fixation of the Mesh

Abstract

Single-port laparoscopic surgery has been used increasingly in treatment of a variety of conditions, and one recently introduced technique is single-port laparoscopic total extraperitoneal (SPLTEP) hernia repair. The aim of this study was to evaluate the safety and technical feasibility of SPLTEP hernia repair without fixation of the mesh. Methods: From June 2010 to October 2012, 112 consecutive patients underwent SPLTEP hernia repair. Results: We performed 129 inguinal hernia repairs in 112 patients, 17 were bilateral and 95 unilateral. There were 107 indirect hernias (83.0%), 20 direct hernias, and 2 hernias had both of types. Successful SPLTEP hernia repair was performed in 110 patients, with two conversions to an open surgical approach. Median operative times for unilateral and bilateral hernias were 70 minutes (40~145 minutes) and 90 minutes (67~135 minutes), respectively, and the hospital stay was 1 day (1~5 days). Postoperative complications included 10 patients with wound seromas or hematomas, 2 with urinary retention, 4 with groin pain, and 1 with bleeding from the incision site. There were 3 early recurrences (2.4%) during a median follow-up period of 42 months (range, 6~55). Conclusion: SPLTEP inguinal hernia repair without fixation of the mesh is both safe and technically feasible, and provides acceptable operative outcomes. Conduct of a prospective randomized study with long-term follow-up is needed to confirm the benefit of this technique in patients with inguinal hernia.

Single-port laparoscopic appendectomy for perforated appendicitis using ArtiSential® wristed articulated instrument

“…With the advancement of minimally invasive surgery, minimising surgical trauma and improving cosmetic outcomes have evolved as current topics of active discussion, which have led to the development of single-port laparoscopic surgery (SPLS) for the treatment of a variety of conditions including acute appendicitis. [ 4 – 6 ] As the number of incisions has reduced to one umbilical incision, a single access can translate into less post-operative incision pain, fewer wound complications and improved cosmetic outcomes.…”

Actinomycosis of the Appendix Mimicking Cecal Tumor Treated by Single-Port Laparoscopic Approach

“…Since laparoscopic appendectomy was first described in 1983, this approach was rapidly accepted as an adequate option for various kinds of diseases [7]. As minimally invasive surgery has developed, minimizing surgical trauma and improving cosmetic outcomes have evolved as topics of active discussion and have led to development of singleport laparoscopic surgery (SPLS) for treatment of a variety of conditions including acute appendicitis [8][9][10][11].…”