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Single-port versus conventional laparoscopic total extra-peritoneal inguinal hernia repair: a prospective, randomized, controlled clinical trial

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Abstract

Background

The advantage of single-port total extra-peritoneal (TEP) inguinal hernia repair over the conventional technique is still debatable. Our objective was to compare the outcomes of TEP inguinal hernia repair using either a single-port or conventional surgical technique, in two blind randomized groups of patients.

Methods

In this prospective, randomized, double-blind, controlled clinical trial, 100 patients undergoing surgery for unilateral inguinal hernia were randomized into two groups: One group underwent conventional laparoscopic TEP inguinal hernia repair, while the other was selected for single-port TEP repair. Primary endpoint is postoperative pain (VAS), while secondary endpoints are recurrence, chronic pain and complications.

Results

From 100 patients, 49 underwent single-port hernia TEP repair, 50 had conventional three-port TEP hernia repair, and one patient declined to participate after randomization. The two groups were comparable in terms of patient demographics and operative findings. Mean operative time was 49.1(±13.8) min in the conventional group and 54.1(±14.4) min in the single-port group (p = 0.08). Mean hospital stay was 19.7(±5.8) h in the conventional group and 20.5(±6.4) h in the single-port group (p = 0.489). No major complications and no recurrence reported at 11-month follow-up. No statistically significant difference noted in postoperative pain between the two groups at regular intervals.

Conclusions

The outcomes after laparoscopic TEP inguinal hernia repair with a single-port device are similar but not superior to the conventional technique.

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Authors and Affiliations

  1. Department of Surgery, Minimally Invasive Surgical Centre, National University Health System, Singapore, Singapore

    Sujith Wijerathne, Narendra Agarwal, Ahmad Ramzi, Dino H. Liem, Wee B. Tan & Davide Lomanto

  2. Department of General Surgery, National University Health System, NUHS Tower Block, Level 08, 1E, Kent Ridge Road, Singapore, 119228, Singapore

    Sujith Wijerathne

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  1. Sujith Wijerathne
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  2. Narendra Agarwal
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  3. Ahmad Ramzi
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  4. Dino H. Liem
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  6. Davide Lomanto
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Correspondence to Sujith Wijerathne.

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Disclosures

Doctors Sujith Wijerathne, Narendra Agarwal, Ahmad Ramzi, Dino H Liem, Wee B Tan and Professor Davide Lomanto have no conflict of interest and financial ties to disclose.

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Wijerathne, S., Agarwal, N., Ramzi, A. et al. Single-port versus conventional laparoscopic total extra-peritoneal inguinal hernia repair: a prospective, randomized, controlled clinical trial. Surg Endosc 30, 1356–1363 (2016). https://doi.org/10.1007/s00464-015-4378-4

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  • DOI: https://doi.org/10.1007/s00464-015-4378-4

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