Harpreet S Mangat, Dr, Elaine Yip, Dr, Sarah Onida, Dr, Yuen Soon, Mr. Royal Surrey County Hospital, United Kingdom
In the past decade, the laparoscopic approach has gained increasing popularity as a surgical treatment for inguinal hernias. Single port laparoscopic surgery (SPLS) has been developed over the last decade, but has been popularised over the last few years and increasing numbers of reports confirm its safety and feasibility. We published a first series of 16 patients at the Royal Surrey County Hospital in Guildford (Agrawal et al 2009), demonstrating the safety and feasibility of SPLS in our cohort. We suggested that a further larger study was required to further demonstrate the effectiveness of this procedure. This study aimed to follow up from our previous paper, assessing the outcome for 106 patients undergoing the single-port approach for laparoscopic totally extraperitoneal (TEP) inguinal hernia repair.
Between 18 October 2008 and 2nd June 2010, 143 single-port laparoscopic TEP inguinal hernia repairs were performed on 106 patients at the Royal Surrey County Hospital, Guildford, United Kingdom. Patient demographics, type of hernia, incision length, operating time, complications, postoperative hospital stay and recurrence were recorded prospectively.
Of the 106 patients, 100 were male and 6 were female, ranging in age from 21 to 89 years (mean age 56.89 years; median 60.5 years) 143 repairs were carried out. Of these, 69 were unilateral and 37 bilateral.
The operating time was between 15 – 120 minutes, with a mean of 42 minutes (median 40 minutes). For unilateral operations the mean operating time was 39 minutes (median 35 minutes, for bilateral operations the mean operating time was 48 minutes (median 45 minutes).
The mean incision length was 25.31 mm (median 25 mm), with a range of 15-40 mm and the mean scar length for patients followed up was 18.3 mm (median 20mm). There were no mortalities and no recurrences to follow up.
There were 3 cases of wound infection all of which resolved with minor intervention and one case of glue breakdown and wound opening. 82 of the patients were discharged the same day, a further 20 staying for 1 night only, the most common reason for this stay being anti-social hours for discharge and not passing urine (all of these cases resolved).
The authors’ experience in a cohort of 106 patients has shown that single-port laparoscopic TEP inguinal hernia repair is a safe and feasible procedure with minimal post operative complications and short operative time. Further studies are required to assess the long term outcome of SPLS hernia repairs, as well as assessing postoperative patient satisfaction and quality of life.
Program Number: P337