Surgical Endoscopy

, Volume 30, Issue 4, pp 1356–1363 | Cite as

Single-port versus conventional laparoscopic total extra-peritoneal inguinal hernia repair: a prospective, randomized, controlled clinical trial

  • Sujith WijerathneEmail author
  • Narendra Agarwal
  • Ahmad Ramzi
  • Dino H. Liem
  • Wee B. Tan
  • Davide Lomanto



The advantage of single-port total extra-peritoneal (TEP) inguinal hernia repair over the conventional technique is still debatable. Our objective was to compare the outcomes of TEP inguinal hernia repair using either a single-port or conventional surgical technique, in two blind randomized groups of patients.


In this prospective, randomized, double-blind, controlled clinical trial, 100 patients undergoing surgery for unilateral inguinal hernia were randomized into two groups: One group underwent conventional laparoscopic TEP inguinal hernia repair, while the other was selected for single-port TEP repair. Primary endpoint is postoperative pain (VAS), while secondary endpoints are recurrence, chronic pain and complications.


From 100 patients, 49 underwent single-port hernia TEP repair, 50 had conventional three-port TEP hernia repair, and one patient declined to participate after randomization. The two groups were comparable in terms of patient demographics and operative findings. Mean operative time was 49.1(±13.8) min in the conventional group and 54.1(±14.4) min in the single-port group (p = 0.08). Mean hospital stay was 19.7(±5.8) h in the conventional group and 20.5(±6.4) h in the single-port group (p = 0.489). No major complications and no recurrence reported at 11-month follow-up. No statistically significant difference noted in postoperative pain between the two groups at regular intervals.


The outcomes after laparoscopic TEP inguinal hernia repair with a single-port device are similar but not superior to the conventional technique.


Single port Total extra-peritoneal (TEP) Inguinal hernia Randomized trial 



Doctors Sujith Wijerathne, Narendra Agarwal, Ahmad Ramzi, Dino H Liem, Wee B Tan and Professor Davide Lomanto have no conflict of interest and financial ties to disclose.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Sujith Wijerathne
    • 1
    • 2
    Email author
  • Narendra Agarwal
    • 1
  • Ahmad Ramzi
    • 1
  • Dino H. Liem
    • 1
  • Wee B. Tan
    • 1
  • Davide Lomanto
    • 1
  1. 1.Department of Surgery, Minimally Invasive Surgical CentreNational University Health SystemSingaporeSingapore
  2. 2.Department of General SurgeryNational University Health SystemSingaporeSingapore

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