Comparison of conventional versus single incision laparoscopic surgery (SILS) totally extraperitoneal (TEP) inguinal hernia repair

Hayashi Nobuyasu, MD, D, Isao Arai, MD, PhD, Tamura Chieko, MD, Ichiro Ohashi, MDPhD, Inoue Shigeharu, MD

Hannan Chuo Hospital

INTRODUCTION: Single incision laparoscopic surgery (SILS) has recently been deployed in certain surgical procedures including totally extra peritoneal (TEP) inguinal hernia repair. Currently, SILS has been demonstrated to perform with no immediate intra or postoperative complications for inguinal hernia. However, to our knowledge, few studies have reported to show this procedure as a feasible alternative to the standard laparoscopic approach. The aim of this study is to investigate whether SILS-TEP procedure can provide favorable advantage over conventional laparoscopic surgery for the treatment of inguinal hernia.

METHODS AND PROCEDURES: Sixty two patients (16 SILS-TEP and 46 conventional laparoscopic TEP(C-TEP) approach) were enrolled in this study, comparing SILS-TEP to C-TEP for hemi lateral inguinal hernia. SILS-TEP procedure was carried out with a homemade single-port device as we demonstrated before. These patients were analyzed with regard to the patient demographics, length of operation, postoperative pain, postoperative hospital stay, days to return to normal activities or work, as well as the complications. Postoperative pain was assessed using the numerical rating scale (NRS).

RESULTS: There was no conversion to conventional laparoscopic surgery or open surgery in SILS-TEP group. Median NRS at rest were lower in SILS-TEP group at 4 h (6 vs 8, P=0.04), at 12 h (5 vs 7, P=0.04), and at 24 h (4 vs 6, P=0.03) after the operations. Pain the first week after surgery were similar in both groups (P=NS). Regarding the length of operation, SILS-TEP group (median 119 min) was significantly longer than that of the C-TEP group (median 92 min) (P < 0.001) There was no surgical mortality or reintervention within 30 days in either group. There were no significant difference in other perioperative outcomes between SILS-TEP group and C-TEP group.

CONCLUSIONS: Although the longer duration of surgery tends to be required, SILS-TEP provided better pain control within 24 hours after the operation than C-TEP for inguinal hernia repair.

Session: Poster Presentation

Program Number: P297

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