Enrique Luque de León, MD, Manuel Muñoz Juárez, MD, FACS, FASCRS, Fernando Cordera Gozález de Cosío, MD, Rodrigo Arrangoiz Majul, MS, MD, FACS, David Caba Molina, MD, MS, MPH, Jorge Sánche García, MD, Efraín Cruz González, MD, Eduardo F Moreno Paquentín, MD. The American British Cowdray Medical Center
Introduction: Minilaparoscopy (Mini) is a modality of minimally invasive surgery that attempts to produce less surgical trauma to the abdominal wall by reducing the diameter of surgical instruments to 3 mm. Searching for better outcomes in inguinal hernia repair, surgeons have looked for new and less invasive alternatives such as single-incision surgery, single-port surgery and Mini. Minilaparoscopic transabdominal preperitoneal hernia repair (Mini-TAPP) demonstrates some of the known advantages of Mini general surgery procedures such as enhanced visualization, improved dexterity and great cosmetic outcome. It is safe and reproducible since it does not differ from standard laparoscopy. The purpose of this report is to describe our first experience with Mini-TAPP technique to treat inguinal hernia at The American British Cowdray Medical Center in Mexico City.
Methods and procedures: An observational, retrospective and descriptive study was performed including 24 patients who were treated at The American British Cowdray Medical Center in Mexico City, from March 2013 to July 2015. We included patients that presented with unilateral or bilateral inguinal hernia. Exclusion criteria were patients sustaining giant inguino-scrotal hernia, and patient refusing to undergo minilaparoscopic surgery. All patients signed an informed written consent. Mini-TAPP technique was used as the standard treatment in all cases. All procedures were performed by the same surgeon. Operative time, use of analgesics, time to discharge, complications, and conversion to standard 5 mm instruments or open surgery were registered. Prisma 6 Software.
Results: Twenty four consecutive patients were operated at The ABC Medical Center in Mexico City. Mean age was 47.5 years (19 – 94 years). There were 16 males and 8 females. Seven patients presented with unilateral hernia, while 17 had bilateral disease. A total of 41 inguinal hernias were minilaparoscopically treated. Average operative time per hernia was 48.2 minutes (40 – 160 minutes, including bilateral procedures). Mean hospital stay was 26 hours (24 – 36 hours). Only one patient required the use of opiods in addition to ketorolac. There were no conversion to regular laparoscopy neither to open approach. There were no major surgical complications.
Conclusions: Our results confirm that Mini-TAPP technique appears to be safe, simple and reproducible. It features advantages over standard laparoscopic surgery as it allows for better visualization, enhances dexterity and produces great cosmetic results. It might cause less pain and faster recovery since abdominal wall trauma is limited. Comparative, randomized trials with adequate sample must be performed to address our hypotesis.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88115
Program Number: P696
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster