Gasless single-incision laparoscopic inguinal hernia repair: initial experience
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Laparoscopic hernioplasty has been gaining its popularity in the past decade for its rapid recovery. Single-incision surgery, as its possible advancement, has also received more attention. Traditional laparoscopic surgery with carbon dioxide insufflation precluded patients with underlying cardiovascular or pulmonary disease from minimal invasive surgery. We report our early experience with gasless single-incision laparoscopic inguinal hernia repair via totally extraperitoneal (TEP) approach.
Between 2010 and 2012, 15 consecutive patients underwent gasless laparoscopic inguinal hernia repair by the same surgeon, using abdominal wall lifting technique with a self-tailored device. Patient demographics, hernia characteristics, operative findings and postoperative outcomes were analyzed prospectively.
Of the 15 patients, all had unilateral hernia. Two presented with acute incarceration, in which one required bowel resection. There was no conversion to open surgery or insertion of additional ports. The median operating time was 80 min (range 51–130) for elective repair and 178 min (range 135–220) for emergency repair. The median hospital stay was 1 day (range 1–6) with minimal requirement of analgesics. Median time taken to resume normal activity was 2 days (range 1–6). No major medical complications or mesh infection was encountered. One patient developed hematoma and was successfully managed by salvage laparoscopic reoperation. During a median follow-up of 54 months (range 38–60), none experienced recurrence.
Gasless single-incision TEP is feasible with favorable results, even in high-risk patients with compromised cardiorespiratory status. This technique can also be applied to emergency setting in patients with incarcerated inguinal hernia requiring bowel resection. Future large scale randomized study is needed to verify the effectiveness of this technique.
KeywordsSingle port Gasless Total extraperitoneal repair Inguinal hernia
Compliance with ethical standards
Conflict of interest
The following authors, M. W. V. N. and K. C. N., have no conflicts of interest or financial ties to disclose.
The procedure protocol was approved in our surgical developmental review board.
Human and animal rights
Compliance with ethical standards was adhered to through Institutional Review Board approval and the study including human participants have been performed in accordance with the ethical standards of the Declaration of Helsinki and its later amendments.
Operation was arranged after receiving informed consent from the patient.
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