Yoshiyuki Kawakami, MD, PhD, Hidenori Fujii, MD, PhD, Ryuhei Ohnishi, MD, Makoto Yoshida, MD, PhD, Hidemaro Yoshiba, MD, PhD, Koji Doi, MD, PhD, Toshiharu Aotake, MD, PhD, Fumie Tanaka, MD, Yuki Hirose, MD, PhD. Japanese Red Cross Fukui Hospital
Aims: Recently, reduced port laparoscopic surgery using minilaparoscopic instruments has been widely adopted as innovative features in minimally invasive surgery. We previously reported that the application of newly developed 3mm minilaparoscopic instruments with supra-pubic approach in combining conventional 5mm trocar at umbilicus to trans-umbilical single port access laparoscopic appendectomy could be feasible with excellent cosmetic result. Thus we attempted to apply modified technique for trans-abdominal preperitoneal (TAPP) incarcerated obturator hernia repair using minilaparoscopic instruments.
Methods: From April of 2014 to August of 2016, 2 consecutive patients were assigned to undergo minilaparoscopic TAPP obturator hernia repair at our hospital. We conducted to study our modified technique using reusable metallic trocar (ENDOTIPTM, 3.3, 6mm in diameter, KARL STORZ GmbH & Co. KG, Tuttlingen, Germany) as a working port, and VERSAPORTTM, 5mm in diameter, COVIDIEN, INC., Mansfield, MA, USA, XCELTM, 5mm in diameter, ETHICON ENDO-SURGERY, INC., Pittsburgh, PA, USA) as a camera port. Straight-type grasping forceps and dissecting forceps (3.3 mm in diameter) were used through the left lower abdominal quadrant port with the triangular co-axial setup. Ventralight STTM (BARD) was used in TAPP cases and SoftmeshTM (BARD), ProloopTM (ATRIUM) were used in open cases. Results: Clinical records of 8 cases of open obturator hernia repair (From February of 2010 to August of 2016) were analyzed retrospectively in background factors, operative time and length of hospital stay. Of them, we had 2 cases with modified TAPP (female 2, average age of 86.0, range 86-86) as was 85.6 (f 8), 80-91 in the control group. The average operative time in the modified group was 98.0 min (62-134), same as that of 94.1 (51-162) in the control group. The median hospital stay in the modified group was 8.5 days (8-9), significantly shorter than that of 21.5 (9-63) in the control group. Postoperative complications were not observed in all cases.
Conclusions: We conclude that modified technique for TAPP incarcerated obturator hernia repair could be a promising option with safety and an attractive advantage of better cosmetic result in managing this condition.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 78975
Program Number: P052
Presentation Session: Poster (Non CME)
Presentation Type: Poster
