Single-port versus conventional three-port laparoscopic totally extraperitoneal inguinal hernia repair: a randomized controlled trial

Choi, Byung Jo; Jeong, Won Jun; Lee, I. K.; Lee, S. C.

doi:10.1007/s10029-016-1499-1

Cited by 24 publications

(61 citation statements)

References 19 publications

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“…Very limited information only could be found on the transabdominal preperitoneal (TAPP) approach. The literature search identified four RCTs [144–147] (n = 398) on this topic and one meta-analysis [148]. Only three of the four RCTs were included in this meta-analysis as one of the trials was published later.…”

Section: Resultsmentioning

confidence: 99%

European association for endoscopic surgery (EAES) consensus statement on single-incision endoscopic surgery

et al. 2019

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BackgroundLaparoscopic surgery changed the management of numerous surgical conditions. It was associated with many advantages over open surgery, such as decreased postoperative pain, faster recovery, shorter hospital stay and excellent cosmesis. Since two decades single-incision endoscopic surgery (SIES) was introduced to the surgical community. SIES could possibly result in even better postoperative outcomes than multi-port laparoscopic surgery, especially concerning cosmetic outcomes and pain. However, the single-incision surgical procedure is associated with quite some challenges.MethodsAn expert panel of surgeons has been selected and invited to participate in the preparation of the material for a consensus meeting on the topic SIES, which was held during the EAES congress in Frankfurt, June 16, 2017. The material presented during the consensus meeting was based on evidence identified through a systematic search of literature according to a pre-specified protocol. Three main topics with respect to SIES have been identified by the panel: (1) General, (2) Organ specific, (3) New development. Within each of these topics, subcategories have been defined. Evidence was graded according to the Oxford 2011 Levels of Evidence. Recommendations were made according to the GRADE criteria.ResultsIn general, there is a lack of high level evidence and a lack of long-term follow-up in the field of single-incision endoscopic surgery. In selected patients, the single-incision approach seems to be safe and effective in terms of perioperative morbidity. Satisfaction with cosmesis has been established to be the main advantage of the single-incision approach. Less pain after single-incision approach compared to conventional laparoscopy seems to be considered an advantage, although it has not been consistently demonstrated across studies.ConclusionsConsidering the increased direct costs (devices, instruments and operating time) of the SIES procedure and the prolonged learning curve, wider acceptance of the procedure should be supported only after demonstration of clear benefits.

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Section: Resultsmentioning

confidence: 99%

European association for endoscopic surgery (EAES) consensus statement on single-incision endoscopic surgery

et al. 2019

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“…Based on the current European Hernia Society guidelines, the methods of choice for the treatment of inguinal hernia are the Lichtenstein and totally extra peritoneal (TEP) repairs [12]. 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].…”

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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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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“…With regard to postoperative pain and recovery, our results showed no increase in visual analogue scale score, analgesic requirements, and days to return to activities of daily living compared with those previously reported for SP TEP under general anesthesia (Table 1 ). [ 3 ]…”

Section: Discussionmentioning

confidence: 99%

Abdominal peripheral nerve block as the only anesthetic technique for totally extraperitoneal endoscopic inguinal hernia repair

Kwon

Bang²,

Soh³

et al. 2018

Medicine

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Rationale:Laparoscopic totally extraperitoneal (TEP) inguinal hernia repair is a rapidly evolving, minimally invasive treatment modality for inguinal hernia. Compared with open hernia repair, this method requires a smaller incision, has cosmetic advantages, and facilitates rapid recovery and early return to daily activities because of less postoperative pain. Because general anesthesia is essential for TEP hernia repair, it cannot be performed on patients who have an increased risk of developing complications when placed under general anesthesia.Patient concerns:We report 2 cases of single-port laparoscopic TEP (SP TEP) that were performed using only an abdominal peripheral nerve block (PNB) at our institute. General anesthesia and neuraxial block were dangerous for both patients owing to severe heart failure and severe chronic obstructive pulmonary disease (COPD).Diagnoses:They were diagnosed with an inguinal hernia requiring surgery.Interventions:Hence, the anesthesiologist and surgeon decided to attempt a PNB to avoid complications from general anesthesia and allow faster recovery. An ipsilateral transversus abdominis plane block as well as a rectus sheath block and inguinal canal block were administered via ultrasound guidance.Outcomes:The patients did not report any pain, and no rescue drug was administrated. The operation times were 65 and 62minutes in patients 1 and 2, respectively. No intraoperative complications were noted. Patient 1 was discharged the day after the surgery, whereas patient 2 was discharged on the same day as the surgery.Lessons:TEP hernia repair using abdominal PNB anesthesia seemed to be a safe and feasible technique without causing any additional complications. However, the use of abdominal PNB anesthesia alone for TEP hernia repair as an alternative to general anesthesia requires further investigation using a larger cohort.

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Single-port versus conventional three-port laparoscopic totally extraperitoneal inguinal hernia repair: a randomized controlled trial

Abstract: The outcomes of SP TEP hernia repair for operation time and morbidities were comparable to CL TEP, and postoperative pain was lower at 7 days than in CL TEP hernia repair. The SP TEP technique can be recommended as an alternative treatment for inguinal hernia repair in experienced hands.

Cited by 24 publications

References 19 publications

European association for endoscopic surgery (EAES) consensus statement on single-incision endoscopic surgery

European association for endoscopic surgery (EAES) consensus statement on single-incision endoscopic surgery

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

Abdominal peripheral nerve block as the only anesthetic technique for totally extraperitoneal endoscopic inguinal hernia repair

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