Prospective randomized study comparing single-incision laparoscopic versus multi-trocar laparoscopic totally extraperitoneal (TEP) inguinal hernia repair at 2 years

Abstract

Background: Inguinal hernia repair via multi-trocar laparoscopy (MTL) has gained an increasing popularity worldwide. Single-incision laparoscopy (SIL) has been introduced to reduce the port-related complications and to improve the cosmetic results. The authors report a prospective randomized study comparing SIL versus MTL totally extraperitoneal (TEP) inguinal hernia repair.

Methods: Between January 2013 and May 2015, 113 versus 97 patients were prospectively randomized between SILTEP and MTLTEP. Perioperative, short-term, and mid-term outcomes have been assessed. The primary endpoint was the mid-term outcomes (late postoperative complications, late inguinal hernia recurrence, surgical and cosmetic satisfactions). Secondary endpoints were perioperative outcomes (operative time, mesh fixation, operative complications, postoperative pain, and hospital stay) and short-term outcomes (early postoperative complications, early inguinal hernia recurrence, and days to return to normal activities).

Results: After a mean follow-up of 27 ± 8 months, a statistically significant difference was found between the two groups in terms of mean operative time for both unilateral and bilateral inguinal hernia repair (p = 0.016; p = 0.039) and cosmetic satisfaction (p = 0.003).

Conclusion: Perioperative, short-term, and mid-term outcomes were comparable between the two groups. At 2-year follow-up, a significant shorter operative time after MTLTEP and a greater cosmetic satisfaction after SILTEP have been found.

Keywords: Inguinal hernia; Laparoscopy; Mid-term outcomes; Single-incision laparoscopy; TEP.