A comparative study of standard versus laparoendoscopic single-site surgery (LESS) totally extraperitoneal (TEP) inguinal hernia repair
Journal
Surgical Endoscopy
Journal Volume
25
Journal Issue
9
Pages
2879-2883
Date Issued
2011
Author(s)
Abstract
Background Laparoscopic inguinal hernia repair has been around since the 1990s. A novel surgical approach known as laparoendoscopic single-site surgery (LESS) has been developed to reduce the port-related morbidities and improve the cosmetic outcomes of laparoscopic surgery, including totally extraperitoneal (TEP) inguinal hernia repair. The aim of the present study was to evaluate the safety and feasibility of the LESS TEP technique for inguinal hernia repair and compare the outcomes with the standard TEP approach. Methods Between January and May 2009, 54 consecutive healthy patients (48 men and 6 women) underwent LESS TEP inguinal hernia repair at our institute. All procedures were performed using our homemade single port for simultaneous passage of the laparoscope and instruments. The perioperative data, including patient age, sex, body mass index (BMI), hernia characteristics, operative time, complications, length of hospital stay, return to normal activity, pain score, and cosmetic result, were prospectively collected. Results All LESS TEP procedures were completed successfully without conversion to standard laparoscopic or open surgery. A total of 98 LESS TEP hernia repairs were performed in 54 patients and compared with 152 standard TEP operations. The mean operative time was significantly shorter in the standard TEP series (61.8 ± 26.0 vs. 70.9 ± 23.8 min, p = 0.04). Other perioperative parameters, including the length of hospital stay, time until return to full activity, complication rate, pain score, and cosmetic result, were all comparable between the two techniques. Conclusion Our short-term experience with LESS TEP inguinal hernia repair has shown that in experienced hands, inguinal hernia repair via the LESS TEP technique is as safe as the standard TEP technique. However, based on our evidence, we currently believe that the LESS TEP technique is not an efficacious surgical alternative to the standard TEP technique for inguinal hernias. ? 2011 Springer Science+Business Media, LLC.
SDGs
Other Subjects
abdominal injury; adult; article; body mass; clinical effectiveness; controlled study; feasibility study; female; hematoma; hernioplasty; hospitalization; human; inguinal hernia; intermethod comparison; laparoendoscopic single site surgery; laparoscopic surgery; length of stay; major clinical study; male; operation duration; outcome assessment; pain assessment; patient safety; perioperative period; postoperative complication; priority journal; recurrent disease; risk assessment; seroma; subcutaneous emphysema; surgical approach; total extraperitoneal inguinal hernia repair; urine retention
Publisher
Springer New York LLC
Type
journal article