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. 2011 Jan-Mar;15(1):47-52.
doi: 10.4293/108680811X13022985131174.

Safety and efficacy of single incision laparoscopic surgery for total extraperitoneal inguinal hernia repair

Hanh Tran  1
Affiliations

Safety and efficacy of single incision laparoscopic surgery for total extraperitoneal inguinal hernia repair

Hanh Tran. JSLS. 2011 Jan-Mar.

Abstract

Almost 20 years after the first laparoscopic inguinal hernia repair was performed, single incision laparoscopic surgery (SILS™) is set to revolutionize minimally invasive surgery. However, the loss of triangulation must be overcome before the technique can be popularized. This study reports the first 100 laparoscopic total extraperitoneal hernia repairs using a single incision. The study cohort comprised 68 patients with a mean age of 44 (range, 18 to 83): 36 unilateral and 32 bilateral hernias. Twelve patients also underwent umbilical hernia repair with the Ventralex patch requiring no additional incisions. A 2.5-cm to 3-cm crescentic incision within the confines of the umbilicus was performed. Standard dissecting instruments and 52-cm/5.5-mm/30(0) laparoscope were used. Operation times were 50 minutes for unilateral and 80 minutes for bilateral. There was one conversion to conventional 3-port laparoscopic repair and none to open surgery. Outpatient surgery was achieved in all (except one). Analgesic requirements were minimal: 8 Dextropropoxyphene tablets (range, 0 to 20). There were no intraoperative or postoperative complications with a high patient satisfaction score. Single-incision laparoscopic hernia repair is safe and efficient simply by modifying dissection techniques (so-called "inline" and "vertical"). Comparable success can be obtained while negating the risks of bowel and vascular injuries from sharp trocars and achieving improved cosmetic results.

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Figures

Figure 1.
Figure 1.
Insertion of SILSport in infraumbilical incision for TEP inguinal hernia repair.
Figure 2.
Figure 2.
Inline dissection showing right hand pulling backward and left hand pushing forward shown by increased distance between the 2 graspers from left to right (see arrows).
Figure 3.
Figure 3.
“Vertical” dissection with graspers on either side of scope as seen by increase in vertical separation of graspers shown by arrows.
Figure 4.
Figure 4.
Single-incision laparoscopic inguinal hernia repair with or without umbilical hernia repair results in inconspicuous scars (3 months postoperation).
See this image and copyright information in PMC

References

    1. Bassini E. Nuovo metodo operativo per la cura dell'ernia inguinale. Padua, 1889
    1. Wantz G. The operation of Bassini as described by Attilio Catterina. Surg Gynecol Obstet. 1989;168(1):67–80 - PubMed
    1. Sachs M, Damm M, Encke A. Historical evolution of inguinal hernia repair. World J Surg. 1997;21(2):218–23 - PubMed
    1. Shouldice E. Surgical treatment of hernia. Ontario Med Rev. 1945
    1. Lichenstein IL. Herniorrhaphy. A personal experience with 6,321 cases. Am J Surg. 1987;153(6):553–559 - PubMed

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