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KMID : 0371420211000010047
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Annals of Surgical Treatment and Research
2021 Volume.100 No. 1 p.47 ~ p.53
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Single incision laparoscopic totally extraperitoneal hernioplasty: lessons learned from 1,231 procedures
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Lee Yoo-Jung
Kim Ji-Hoon
Kim Chang-Hyun
Lee Gyeo-Ra
Lee Yoon-Suk
Kim Hyung-Jin
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Abstract
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Purpose: Although there are many articles about single incision laparoscopic (SIL) hernioplasty, a large-scale study or article about its long-term outcome has not been reported yet. The aim of this study is to assess short- and long-term outcomes of SIL totally extraperitoneal (TEP) hernia repair with large number of cases.
Methods: A prospectively collected database containing details of 1,231 procedures in 1,129 consecutive patients who underwent SIL-TEP hernia repair between June 2010 and December 2017 at a single institution was retrospectively analyzed. SIL-TEP hernia repair was performed using a glove single port device and standard laparoscopic instruments. Recurrence rate of SIL-TEP hernia repair was analyzed by a telephone questionnaire.
Results: Among 1,129 patients, 1,027 (91.0%) had unilateral hernia and 102 (9.0%) had bilateral hernia. There were 12 (1.1%) conversions to single or 3 ports laparoscopic transabdominal preperitoneal hernioplasty or Lichtenstein repair. Mean operative time was 40.3 minutes for unilateral hernia and 61.6 minutes for bilateral hernia. Intraoperative complication rate was 21.8%. Most intraoperative complications were peritoneum or sac tearing (20.1%). Postoperative complications occurred in 97 (8.6%) cases, most of which were minor morbidity except for 1 mesh infection. Five-year recurrence rate was 4%.
Conclusion: SIL-TEP hernia repair is safe and technically feasible with acceptable short- and long-term outcomes. Large-scale randomized controlled trials comparing SIL-TEP hernia repair with conventional laparoscopic TEP are needed to confirm these results.
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KEYWORD
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Inguinal hernia, Laparoscopy
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