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Laparoendoscopic single-site totally extraperitoneal adult inguinal hernia repair: initial 100 patients

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Abstract

Background

This report aims to describe the authors’ initial experience with laparoendoscopic single-site (LESS) totally extraperitoneal (TEP) inguinal hernia repair in 100 patients.

Methods

Patients who underwent an elective LESS TEP inguinal hernia repair between December 2008 and September 2010 in a single center were enrolled prospectively in this study. Patient demographic data, hernia characteristics, and operative and postoperative outcomes were analyzed. An Alexis wound retractor was placed through the 2-cm subumbilical incision as a homemade transumbilical access platform after the preperitoneal space was created by a balloon dissector. Standard procedures of TEP all were finished using conventional straight laparoscopic instruments.

Results

Of the 100 patients in this study, 2 underwent conversion to LESS transabdominal preperitoneal (TAPP) repair. The remaining 98 patients received successful LESS TEP inguinal hernia repair by a single surgeon. No patient required open or conventional laparoscopic conversion. However, one patient did experience recurrence. The mean operative time was 64.2 min, and the hospital stay was 1.54 days. One patient with a history of bladder surgery had a minor intraoperative bladder injury. No major postoperative complication occurred, but 11 patients had seroma or hematoma, 2 had epididymitis, 2 had urinary tract infection, 1 had wound dehiscence, 1 had wound infection, and 1 had urinary retention. This single-arm observational study was limited by the absence of a control cohort.

Conclusions

Based on our experience, in the hands of experienced laparoscopic surgeons, LESS TEP repair for adult inguinal hernia using the homemade port as an access platform is feasible and safe and provides acceptable operative outcomes.

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Disclosures

Shiu-Dong Chung, Chao-Yuan Huang, Shuo-Meng Wang, Shun-Fa Hung, Yao-Chou Tsai, Shih-Chieh Chueh, and Hong-Jeng Yu have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Surgery, Far-Eastern Memorial Hospital, Taipei, Taiwan

    Shiu-Dong Chung & Shun-Fa Hung

  2. Department of Urology, National Taiwan University Hospital, Taipei, Taiwan

    Shiu-Dong Chung, Chao-Yuan Huang, Shuo-Meng Wang, Shih-Chieh Chueh & Hong-Jeng Yu

  3. Division of Urology, Department of Surgery, Buddhist Tzu Chi General Hospital, Taipei Branch, Taipei, Taiwan

    Yao-Chou Tsai

  4. Department of Urology, Tzu Chi University, Medical College, Hualien, Taiwan

    Yao-Chou Tsai

  5. Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan

    Yao-Chou Tsai

  6. Glickman Urologic and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA

    Shih-Chieh Chueh

  7. Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA

    Shih-Chieh Chueh

Authors
  1. Shiu-Dong Chung
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  2. Chao-Yuan Huang
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  3. Shuo-Meng Wang
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  4. Shun-Fa Hung
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  5. Yao-Chou Tsai
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  6. Shih-Chieh Chueh
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  7. Hong-Jeng Yu
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Corresponding author

Correspondence to Yao-Chou Tsai.

Additional information

Authors S. D. Chung and C. Y. Huang contributed to this work equally.

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Chung, SD., Huang, CY., Wang, SM. et al. Laparoendoscopic single-site totally extraperitoneal adult inguinal hernia repair: initial 100 patients. Surg Endosc 25, 3579–3583 (2011). https://doi.org/10.1007/s00464-011-1761-7

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  • DOI: https://doi.org/10.1007/s00464-011-1761-7

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