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Single-incision laparoscopic transabdominal preperitoneal herniorrhaphy for recurrent inguinal hernias: preliminary surgical results

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Abstract

Background

Since the early 1990s, laparoscopy has provided surgeons with new and innovative ways to treat various surgical problems. Many of these minimally invasive techniques have gained universal acceptance by demonstrating improved patient outcomes. Single-incision laparoscopic surgery (SILS) was developed with the aim of reducing the invasiveness of traditional laparoscopy. Laparoscopic transabdominal preperitoneal (TAPP) herniorrhaphy via the three-trocar technique is widely used for recurrent inguinal hernia. To the author’s knowledge, this report describes first series of SILS TAPP for recurrent inguinal hernia repair.

Methods

From April 2009 to March 2010, 15 single-incision laparoscopic TAPP repairs of recurrent inguinal hernia were performed by the same surgical team. The data collected prospectively included patient demographics, type of hernia, operative time, complications, postoperative hospital stay, and recurrence. The umbilicus was the sole point of entry for all patients using a single port, and the same operative technique was used in all cases.

Results

The SILS TAPP procedure was performed successfully for all the patients, and none required conversion to an open procedure or a conventional laparoscopic hernia repair by the addition of more entry ports. The mean operative time was 51 ± 17 min. No intra- or postoperative complications were recorded. There was no evidence of early recurrence during a mean follow-up period of 130 ± 77 days.

Conclusion

Based on this experience, the author believes that SILS approach is technically feasible and safe using standard and slightly modified instruments for standard TAPP. The cosmetic benefit is clear, but the advantages of SILS TAPP over conventional laparoscopic surgery during long-term follow-up evaluation will require further randomized clinical trials.

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References

  1. Gray SH, Hawn MT, Itani KM (2008) Surgical progress in inguinal and ventral incisional hernia repair. Surg Clin North Am 88:17–26

    Article  PubMed  Google Scholar 

  2. Rutkow IM (2003) Demographic and socioeconomic aspects of hernia repair in the United States in 2003. Surg Clin North Am 83:1045–1051

    Article  PubMed  Google Scholar 

  3. Memon MA, Cooper NJ, Memon B, Memon MI, Abrams KR (2003) Metaanalysis of randomized clinical trials comparing open and laparoscopic inguinal hernia repair. Br J Surg 90(12):1479–1492

    Article  PubMed  CAS  Google Scholar 

  4. McCormack K, Scott N, Go PM, Ross SJ, Grant A, Collaboration the EU Hernia Trialists (2003) Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev 1:CD001785

    PubMed  Google Scholar 

  5. Takata MC, Duh QY (2008) Laparoscopic inguinal hernia repair. Surg Clin North Am 88:157–178

    Article  PubMed  Google Scholar 

  6. Aufenacker TJ, de Lange DH, Burg MD, Kuiken BW, Hensen EF, Schoots IG, Gouma DJ, Simons MP (2005) Hernia surgery changes in the Amsterdam region 1994–2001: decrease in operations for recurrent hernia. Hernia 9:46–50

    Article  PubMed  CAS  Google Scholar 

  7. Bisgaard T, Bay-Nielsen M, Christensen IJ, Kehlet H (2007) Risk of recurrence 5 years or more after primary Lichtenstein mesh and sutured inguinal hernia repair. Br J Surg 94:1038–1040

    Article  PubMed  CAS  Google Scholar 

  8. Scheuerlein H, Schiller A, Schneider C, Scheidbach H, Tamme C, Kockerling F (2003) Totally extraperitoneal repair of recurrent inguinal hernia. Surg Endosc 17:1072–1076

    Article  PubMed  CAS  Google Scholar 

  9. Mahon D, Decadt M, Rhodes M (2003) Prospective randomized trial of laparoscopic (transabdominal preperitoneal) vs open (mesh) repair for bilateral and recurrent inguinal hernia. Surg Endosc 17:1386–1390

    Article  PubMed  CAS  Google Scholar 

  10. Feliu X, Jaurrieta E, Vinas X, Macarulla E, Abad JM, Fernandez-Sallent E (2004) Recurrent inguinal hernia: a ten-year review. J Laparoendosc Adv Surg Tech A 14:362–367

    PubMed  Google Scholar 

  11. Eklund A, Rudberg C, Leijonmarck CE, Rasmussen I, Spangen L, Wickbom G, Wingren U, Montgomery A (2007) Recurrent inguinal hernia: randomized multicenter trial comparing laparoscopic and Lichtenstein repair. Surg Endosc 21:634–640

    Article  PubMed  CAS  Google Scholar 

  12. Leibl BJ, Jager C, Kraft B, Kraft K, Schwarz J, Ulrich M, Bittner R (2005) Laparoscopic hernia repair: TAPP or/and TEP? Langenbecks Arch Surg 390:77–82

    Article  PubMed  CAS  Google Scholar 

  13. Rosen MJ (2006) Laparoscopic transabdominal preperitoneal inguinal hernia repair. Operat Tech Gen Surg 8:45–51

    Article  Google Scholar 

  14. Novitsky YW, Czerniach DR, Kercher KW, Kaban GK, Gallagher KA, Kelly JJ, Heniford BT, Litwin DE (2007) Advantages of laparoscopic transabdominal preperitoneal herniorrhaphy in the evaluation and management of inguinal hernias. Am J Surg 193:466–470

    Article  PubMed  Google Scholar 

  15. Chamberlain RS, Sakpal SV (2009) A comprehensive review of single-incision laparoscopic surgery (SILS) and natural orifice transluminal endoscopic surgery (NOTES) techniques for cholecystectomy. J Gastrointest Surg 13:1733–1740

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  19. 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 

  20. Rahman SH, John BJ (2010) Single-incision laparoscopic transabdominal preperitoneal mesh hernia repair: a feasible approach. Hernia 14:329–331

    Article  PubMed  CAS  Google Scholar 

  21. Menenakos C, Kilian M, Hartmann J (2010) Single-port access in laparoscopic bilateral inguinal hernia repair: first clinical report of a novel technique. Hernia 14:309–312

    Article  PubMed  CAS  Google Scholar 

  22. Ishikawa N, Kawaguchi M, Shimizu S, Matsunoki A, Inaki N, Watanabe G (2010) Single-incision laparoscopic hernioplasty with the assistance of the Radius Surgical System. Surg Endosc 24:730–731

    Article  PubMed  Google Scholar 

  23. 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  PubMed  CAS  Google Scholar 

  24. Scott NW, McCormack K, Graham P, Go PM, Ross SJ, Grant AM (2002) Open mesh versus nonmesh for repair of femoral and inguinal hernia. Cochrane Database Syst Rev 4:CD002197

    PubMed  Google Scholar 

  25. Brunicardi FC (2010) Inguinal hernias. In: Brunicardi FC (ed) Schwartz’s principles of surgery, 9th edn. McGraw-Hill, New York, pp 2514–2586

    Google Scholar 

  26. Arregui ME, Davis CJ, Yucel O, Nagan RF (1992) Laparoscopic mesh repair of inguinal hernia using a preperitoneal approach: a preliminary report. Surg Laparosc Endosc 2:53–58

    PubMed  CAS  Google Scholar 

  27. McKernan JB, Laws HL (1993) Laparoscopic repair of inguinal hernias using a totally extraperitoneal prosthetic approach. Surg Endosc 7:26–28

    Article  PubMed  CAS  Google Scholar 

  28. Wake BL, McCormack K, Fraser C, Vale L, Perez J, Grant A (2005) Transabdominal preperitoneal (TAPP) vs totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair. Hernia 9:109–114

    Article  PubMed  Google Scholar 

  29. Filipovic-Cugura J, Kirac I, Kulis T, Jankovic J, Bekavac-Beslin M (2009) Single-incision laparoscopic surgery (SILS) for totally extraperitoneal (TEP) inguinal hernia repair: first case. Surg Endosc 23:920–921

    Article  PubMed  Google Scholar 

  30. Merchant AM, Cook MW, White BC, Davis SS, Sweeney JF, Lin E (2008) Transumbilical Gelport access technique for performing single-incision laparoscopic surgery (SILS). J Gastrointest Surg 13:159–162

    Article  PubMed  Google Scholar 

  31. Pryor AD, Tushar JR, DiBernardo LR (2010) Single-port cholecystectomy with the TransEnterix SPIDER: simple and safe. Surg Endosc 24:917–923

    Article  PubMed  Google Scholar 

  32. Huang CK, Tsai JC, Lo CH, Houng JY, Chen YS, Chi SC, Lee PH (2010) Preliminary surgical results of single-incision transumbilical laparoscopic bariatric surgery. Obes Surg. doi:10.1007/s11695-009-0071-9

  33. Bucher P, Pugin F, Morel P (2010) Transumbilical single-incision laparoscopic sigmoidectomy for benign disease. Colorectal Dis 12:61–65

    Article  PubMed  CAS  Google Scholar 

  34. Lo DJ, Bilimoria KY, Pugh CM (2008) Bowel complications after prolene hernia system (PHS) repair: a case report and review of the literature. Hernia 12:437–440

    Article  PubMed  CAS  Google Scholar 

  35. Rane A, Ahmed S, Kommu SS, Anderson CJ, Rimington PD (2009) Single-port “scarless” laparoscopic nephrectomies: the United Kingdom experience. BJU Int 104:230–233

    Article  PubMed  Google Scholar 

  36. Agrawal S, Shaw A, Soon Y (2010) Single-port laparoscopic totally extraperitoneal inguinal hernia repair with the TriPort system: initial experience. Surg Endosc 24(4):952–956

    Article  PubMed  CAS  Google Scholar 

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Disclosure

Can Kucuk has no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of General Surgery, Erciyes University School of Medicine, 38039, Kayseri, Turkey

    Can Kucuk

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Kucuk, C. Single-incision laparoscopic transabdominal preperitoneal herniorrhaphy for recurrent inguinal hernias: preliminary surgical results. Surg Endosc 25, 3228–3234 (2011). https://doi.org/10.1007/s00464-011-1698-x

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