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Single-incision laparoscopic transabdominal preperitoneal mesh hernioplasty: results in 182 Japanese patients

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Abstract

Background

We introduced single-incision transabdominal preperitoneal (S-TAPP) herniorrhaphy (described herein) at our institution in June 2010. We recently conducted a retrospective study to assess the feasibility and safety of the procedure.

Methods

The study involved 182 patients (159 men, 23 women) who underwent S-TAPP herniorrhaphy between June 2010 and February 2015 for 202 groin hernias (162 unilateral hernias, 20 bilateral hernias). We examined patient characteristics, hernia type and presentation, operation time, conversion to another repair procedure, intraoperative blood loss, postoperative pain, morbidities, and postoperative hospital stay. We further evaluated operation time and morbidity by comparison between cases of simple unilateral hernia and cases of complicated unilateral hernia, which was defined as (1) a recurrent hernia, (2) hernia following radical prostatectomy, or (3) an incarcerated omental or bowel hernia.

Results

Five types of hernia were treated: indirect inguinal, direct inguinal, femoral, combined inguinal, and other (a urinary bladder hernia). Operation time was 92.5 ± 29.1 min for the unilateral hernias and 135.7 ± 24.5 min for the bilateral hernias. No major bleeding occurred. Postoperative pain was short-lived and easily managed. Overall morbidity was 8.2% (15/182 patients), and only one postoperative complication (recurrence) required surgical intervention (repeat S-TAPP). Average postoperative stay was 6.7 ± 2.6 days. Two patients experienced numbness in the outer thigh, but this resolved naturally. One superficial surgical site infection developed and was easily treated. Operation times were greater for the complicated vs. simple hernias, but the time differed significantly (p = 0.02) only between radical prostatectomy-associated hernia and simple hernia. No complicated hernia required conversion to traditional laparoscopic repair, but in simple unilateral hernia group one conversion to traditional laparoscopic repair was required for difficulties encountered in the dissection of the large indirect inguinal hernia sac. The incidence of seroma was higher, though not statistically, in the complicated (n = 3) vs. simple hernia group.

Conclusions

S-TAPP repair of groin hernia was shown to be a feasible, safe procedure. The advantages are well understood, and further studies are warranted to confirm the long-term benefits suggested by our study.

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References

  1. Li J, Wang X, Feng X, Gu Y, Tang R (2013) Comparison of open and laparoscopic preperitoneal repair of groin hernia. Surg Endosc 27:4702–4710

    Article  PubMed  Google Scholar 

  2. Eklund AS, Montgomery AK, Rasmussen IC, Sandbue RP, Bergkvist LA, Rudberg CR (2009) Low recurrence rate after laparoscopic (TEP) and open (Lichtenstein) inguinal hernia repair: a randomized, multicenter trial with 5-year follow-up. Ann Surg 249:33–38

    Article  PubMed  Google Scholar 

  3. Pokorny H, Klingler A, Schmid T, Fortelny R, Hollinsky C, Kawji R, Steiner E, Pernthaler H, Függer R, Scheyer M (2008) Recurrence and complications after laparoscopic versus open inguinal hernia repair: results of a prospective randomized multicenter trial. Hernia 12:385–389

    Article  CAS  PubMed  Google Scholar 

  4. Singh AN, Bansal VK, Misra MC, Kumar S, Rajeshwari S, Kumar A, Sagar R (2012) Testicular functions, chronic groin pain, and quality of life after laparoscopic and open mesh repair of inguinal hernia: a prospective randomized controlled trial. Surg Endosc 26:1304–1317

    Article  PubMed  Google Scholar 

  5. Swadia ND (2011) Laparoscopic totally extra-peritoneal inguinal hernia repair: 9 year’s experience. Hernia 15:273–279

    Article  CAS  PubMed  Google Scholar 

  6. Eklund A, Montgomery A, Bergkvist L, Rudberg C (2010) Chronic pain 5 years after randomized comparison of laparoscopic and Lichtenstein inguinal hernia repair. Br J Surg 97:600–608

    Article  CAS  PubMed  Google Scholar 

  7. Gong K, Zhang N, Lu Y, Zhu B, Zhang Z, Du D, Zhao X, Jiang H (2011) Comparison of the open tension-free mesh-plug, transabdominal preperitoneal (TAPP), and totally extraperitoneal (TEP) laparoscopic techniques for primary unilateral inguinal hernia repair: a prospective randomized controlled trial. Surg Endosc 25:234–239

    Article  PubMed  Google Scholar 

  8. Eklund A, Carlsson P, Rosenblad A, Montgomery A, Bergkvist L, Rudberg C (2010) Long-term cost-minimization analysis comparing laparoscopic with open (Lichtenstein) inguinal hernia repair. Br J Surg 97:765–771

    Article  CAS  PubMed  Google Scholar 

  9. Bucher P, Pugin F, Morel P (2008) Single-port access laparoscopic right hemicolectomy. Int J Colorectal Dis 23:1013–1016

    Article  PubMed  Google Scholar 

  10. Barbaros U, Dinccag A (2009) Single-incision laparoscopic splenectomy: the first two cases. J Gastrointest Surg 13:1520–1523

    Article  PubMed  Google Scholar 

  11. Reavis KM, Hinojosa MW, Smith BR (2008) Single-laparoscopic incision transabdominal surgery sleeve gastrectomy. Obes Surg 18:1492–1494

    Article  PubMed  Google Scholar 

  12. Irwin BH, Rao PP, Stein RJ, Desai MM (2009) Laparoendoscopic single-site surgery in urology. Urol Clin North Am 36:223–235

    Article  PubMed  Google Scholar 

  13. Kucuk C (2011) Single-incision laparoscopic transabdominal preperitoneal herniorrhaphy for recurrent inguinal hernias: preliminary surgical results. Surg Endosc 25:3228–3234

    Article  PubMed  Google Scholar 

  14. Neumayer L, Giobbie-Hurder A, Jonasson O, Neumayer L, Giobbie-Hurder A, Jonasson O, Fitzgibbons R Jr, Dunlop D, Gibbs J, Reda D, Henderson W (2004) Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med 350:1819–1827

    Article  CAS  PubMed  Google Scholar 

  15. Leibl BJ, Schmedt CG, Schwarz J, Däubler P, Kraft K, Schlossnickel B, Bittner R (1998) A single institution’s experience with transperitoneal laparoscopic hernia repair. Am J Surg 175:446–451

    Article  CAS  PubMed  Google Scholar 

  16. EU Hernia Trialists Collaboration (2000) Laparoscopic compared with open methods of groin hernia repair: systematic review of randomized controlled trials. Br J Surg 87:860–867

    Article  Google Scholar 

  17. Memmon MA, Cooper NJ, Memmon B, Memmon MI, Abrams KR (2003) Meta-analysis of randomized clinical trials comparing open and laparoscopic inguinal hernia repair. Br J Surg 90:1479–1492

    Article  Google Scholar 

  18. Feliu X, Clavería R, Besora P, Camps J, Fernández-Sallent E, Viñas X, Abad JM (2011) Bilateral inguinal hernia repair: laparoscopic or open approach? Hernia 15:15–18

    Article  CAS  PubMed  Google Scholar 

  19. Roy P, De A (2010) Single-incision laparoscopic TAPP mesh hernioplasty using conventional instruments: an evolving technique. Langenbecks Arch Surg 395:1157–1160

    Article  PubMed  Google Scholar 

  20. Chowbey PK, Garg N, Sharma A, Khullar R, Soni V, Baijal M, Mittal T (2010) Prospective randomized clinical trial comparing lightweight mesh and heavyweight polypropylene mesh in endoscopic totally extraperitoneal groin hernia repair. Surg Endosc 24:3073–3079

    Article  CAS  PubMed  Google Scholar 

  21. Heikkinen T, Wollert S, Osterberg J, Smedberg S, Bringman S (2006) Early results of a randomised trial comparing Prolene and VyproII-mesh in endoscopic extraperitoneal inguinal hernia repair (TEP) of recurrent unilateral hernias. Hernia 10:34–40

    Article  CAS  PubMed  Google Scholar 

  22. Ross SW, Oommen B, Kim M, Amanda L, Walters AL, Augenstein VA, Heniford BT (2014) Tacks, staples, or suture: method of peritoneal closure in laparoscopic transabdominal preperitoneal inguinal hernia repair effects early quality of life. Surg Endosc. doi:10.1007/s00464-014-3857-3

    Google Scholar 

  23. Lantis JC 2nd, Schwaitzberg SD (1999) Tack entrapment of the ilioinguinal nerve during laparoscopic hernia repair. J Laparoendosc Adv Surg Tech 9:285–289

    Article  Google Scholar 

  24. Ladurner R, Mussack T (2004) Small bowel perforation due to protruding spiral tackers: a rare complication in laparoscopic incisional hernia repair. Surg Endosc 18:1001

    CAS  PubMed  Google Scholar 

  25. Karahasanoglu T, Onur E, Baca B, Hamzaoglu I, Pekmezci S, Boler DE, Kilic N, Altug T (2004) Spiral tacks may contribute to intraabdominal adhesion formation. Surg Today 34:860–864

    Article  PubMed  Google Scholar 

  26. Tai HC, Lin CD, Chung SD, Chueh SC, Tsai YC, Yang SS (2011) A comparative study of standard versus laparoendoscopic single-site surgery (LESS) totally extraperitoneal (TEP) inguinal hernia repair. Surg Endosc 25:2879–2883

    Article  PubMed  Google Scholar 

  27. Yang GP, Tung KL (2014) A comparative study of single incision versus conventional laparoscopic inguinal hernia repair. Hernia. doi:10.1007/s10029-014-1246-4

    Google Scholar 

  28. Yussra Y, Sutton PA, Kosai NR, Razman J, Mishra RK, Harunarashid H, Das S (2013) Single incision laparoscopic surgery (SILS) inguinal hernia repair—recent clinical experiences of this novel technique. Clin Ter 164:425–428

    CAS  PubMed  Google Scholar 

  29. Yilmaz H, Alptekin H (2013) Single-incision laparoscopic transabdominal preperitoneal herniorrhaphy for bilateral inguinal hernias using conventional instruments. Surg Laparosc Endosc Percutan Tech 23:320–323

    Article  PubMed  Google Scholar 

  30. Rahman SH, John BJ (2010) Single-incision laparoscopic trans-abdominal pre-peritoneal mesh hernia repair: a feasible approach. Hernia 14:329–331

    Article  CAS  PubMed  Google Scholar 

  31. Rosenberger RJ, Loeweneck H, Meyer G (2000) The cutaneous nerves encountered during laparoscopic repair of inguinal hernia. Surg Endosc 14:731–735

    Article  CAS  PubMed  Google Scholar 

  32. Seid AS, Amos E (1994) Entrapment neuropathy in laparoscopic herniorrhaphy. Surg Endosc 8:1050–1053

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Ueno Surgical Hospital, Kasuya-gun, Shime, Japan

    K. Tanoue, H. Okino, M. Kanazawa & K. Ueno

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  1. K. Tanoue
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  2. H. Okino
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  3. M. Kanazawa
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  4. K. Ueno
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Correspondence to K. Tanoue.

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The authors have no conflicts of interest or financial ties to declare.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee with the 1964 Helsinki declaration and its later amendments comparable ethical standards.

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Tanoue, K., Okino, H., Kanazawa, M. et al. Single-incision laparoscopic transabdominal preperitoneal mesh hernioplasty: results in 182 Japanese patients. Hernia 20, 797–803 (2016). https://doi.org/10.1007/s10029-016-1540-4

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  • DOI: https://doi.org/10.1007/s10029-016-1540-4

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