Hideto Oishi, MD, PhD, Takayuki Iino, MD, PhD. Murayama Medical Center, National Hospital Organization
Objective: Using 3mm laparoscopic TEP procedure, we describe an effectiveness of postoperative pain suppression. We usually performed the TEP procedure for inguinal hernia cases who had no post history of operation in preperitoneal space, and who had been able to undergo general anesthesia. In our standard TEP procedure, we performed it by 3 port (12-5-5mm). We believe that TEP procedure is a very effective training system for beginner of laparoscopic surgery. For the purpose of diagnosis confirmation and operative method choice and repair confirmation, we usually added intraabdominal observation before and after TEP procedure. However, some cases had postoperative wound pain at their navel. We looked for causes of this pain, and guessed that it was caused by suturing of incisional wound of umbilical ring after intraabdominal observation. For postoperative pain suppression, we tried to prohibit incision of umbilical ring for intraabdominal observation before and after TEP procedure.
Materials and Methods: Without incision of umbilical ring, we performed this procedure to 3 cases by 3mm laparoscope and 3mm forceps in intraabdominal observation before and after TEP procedure. In this new procedure, we performed it with 3 port (5-3-3mm) by 3mm laparoscope and 3mm forceps. And we used 3mm monopolar scissors as an reusable energy device in this procedure.
Result: There were no technical difficulty and no complication in this procedure. Because patients had no complaint of wound pain after this procedure, they took only prophylactic sedative oral medicine between only 3 days after surgery.
Conclusion: Minimally invasive TEP procedure by 3mm laparoscope and 3mm forceps was very effective method for postoperative pain suppression and for economical outcome.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88601
Program Number: P042
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster