Skip to main content
Log in

Single-port endo-laparoscopic surgery (SPES) for totally extraperitoneal inguinal hernia: a critical appraisal of the chopstick repair

  • Original Article
  • Published:
Hernia Aims and scope Submit manuscript

Abstract

Purpose

Developments in minimal access surgery brought a new concept: single-port endolaparoscopic surgery (SPES). The aim of our study is to verify the safety and feasibility of SPES TEP hernia repair and report our initial clinical outcome.

Methods

We prospectively collected data of all patients who underwent SPES TEP repair from May 2009 to December 2010. Data regarding patient demographics, type, size and location of hernia, port devices used, type of mesh and fixation, operative time, complications, length of stay and cosmetic results were collected and analyzed.

Results

A total of 47 patients (36 M, 11 F) underwent 70 SPES TEP hernia repairs; median age was 53 years (range 22–80). 60 % had indirect hernia, 27.5 % direct, 8.5 % pantaloon, 2 % femoral and 2 % recurrent hernias. Mean hernia size was 1.91 ± 0.67 cm. Port devices used include 33 Triport, 12 SILS and 2 SSL. We used anatomical mesh in 20; flat polypropylene in 10 and titanium-coated polypropylene mesh in 17 patients. Fixation of mesh was achieved in 18 patients with absorbable tacks, 8 with titanium tacks, 1 with fibrin glue, and no tack in 20 with anatomical mesh. No conversions occurred and small seroma was reported in 3 (6.3 %) patients. Mean operative time was 96.48 min (range: 50–150). Average hospital stay was 11.8 h (range: 9–26). Median follow-up was 11 months (range 6–18), and no recurrence was noted. 82.6 % patients were very satisfied, and 17.4 % were satisfied with the procedure.

Conclusion

SPES TEP repair is a safe and feasible technique with good patient satisfaction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Ger R (1991) The laparoscopic management of groin hernias. Contemp Surg 39:15–19

    Google Scholar 

  2. Schultz L, Graber J, Pietrafitta J, Hickok D (1990) Laser laparoscopic herniorrhaphy: a clinical trial, preliminary results. J Laparoedosc Surg 1:41–45

    Article  CAS  Google Scholar 

  3. Corbitt J (1991) Laparoscopic herniorrhaphy. Surg Laparosc Endosc 1:23–25

    PubMed  Google Scholar 

  4. Filipi C, Fitzgibbons RJ, Salerno GM, Hart RO (1992) Laparoscopic herniorrhaphy. Surg Clin N Am 72:1109–1124

    PubMed  CAS  Google Scholar 

  5. Liem MS, van der Graaf Y, van Steensel CJ, Boelhouwer RU, Clevers GJ, Meijer WS et al (1997) Comparison of conventional anterior surgery and laparoscopic surgery for inguinal hernia repair. N Engl J Med 336:1541–1547

    Article  PubMed  CAS  Google Scholar 

  6. The MRC Laparoscopic Groin Hernia Trial Group (1999) Laparoscopic versus open repair of groin hernia: a randomized comparison. Lancet 354:185–190

    Article  Google Scholar 

  7. Memon MA, Cooper NJ, Memon B, Memon MI, Abrams KR (2003) Meta-analysis of randomized clinical trials comparing open and laparoscopic inguinal hernia repair. Br J Surg 90:1479–1497

    Article  PubMed  CAS  Google Scholar 

  8. Rattner D, Kalloo A, ASGE/SAGES Working Group (2006) ASGE/SAGES Working Group on Natural Orifice Transluminal Endoscopic Surgery. October 2005. Surg Endosc 20:329–333

    Article  PubMed  CAS  Google Scholar 

  9. Chukwumah C, Zorron R, Marks JM, Ponsky JL (2010) Current status of natural orifice transluminal endoscopic surgery (NOTES). Curr Probl Surg 47:630–668

    Article  PubMed  Google Scholar 

  10. Allemann P, Schafer M, Demartines N (2010) Critical appraisal of single port access cholecystectomy. Br J Surg 97:1476–1480

    Article  PubMed  CAS  Google Scholar 

  11. Romanelli JR, Earle DB (2009) Single-port laparoscopic surgery: an overview. Surg Endosc 23:1419–1427

    Article  PubMed  Google Scholar 

  12. Tracy CR, Raman JD, Cadeddu JA, Rane A (2008) Laparoendoscopic single-site surgery in urology: where have we been and where are we heading? Nat Clin Pract Urol 5:561–568

    Article  PubMed  Google Scholar 

  13. Vidal O, Ginesta’ C, Valentini M, Marti J, Benarroch G, Garcia-Valdecasas JC (2011) Suprapubic single-incision laparoscopic appendectomy: a nonvisible-scar surgical option. Surg Endosc 25:1019–1023 (Epub 2010 Aug 25)

    Article  PubMed  Google Scholar 

  14. 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 (Epub 2009 Jan 27)

    Article  PubMed  Google Scholar 

  15. Jacob BP, Tong W, Reiner M, Vine A, Katz LB (2009) Single incision total extraperitoneal (one SITE) laparoscopic inguinal hernia repair using a single access port device. Hernia 13:571–572

    Article  PubMed  CAS  Google Scholar 

  16. Surgit O (2010) Single Incision laparoscopic surgery for total extraperitoneal repair of inguinal hernias in 23 patients. Surg laparosc Endosc percutan Tech 20:114–118

    Article  PubMed  Google Scholar 

  17. Lau H, Patil NG, Yuen WK, Lee F (2002) Learning curve for unilateral endoscopic totally extraperitoneal (TEP) inguinal hernioplasty. Surg Endosc 16:1724–1728 (Epub 2002 Jul 8)

    Article  PubMed  CAS  Google Scholar 

  18. Lal P, Kajla RK, Chander J, Ramteke VK (2004) Laparoscopic total extraperitoneal (TEP) inguinal hernia repair: overcoming the learning curve. Surg Endosc 18:642–645 (Epub 2004 Mar 19)

    Article  PubMed  Google Scholar 

  19. Palanivelu C, Rajan PS, Rangarajan M, Parthasarathi R, Senthilnathan P, Praveenraj P (2008) Transumbilical endoscopic appendectomy in humans: on the road to NOTES: a prospective study. J Laparoendosc Adv Surg Technol A 18:579–582

    Article  Google Scholar 

  20. Hong TH, You YK, Lee KH (2009) Transumbilical single-port laparoscopic cholecystectomy: scarless cholecystectomy. Surg Endosc 23:1393–1397

    Article  PubMed  Google Scholar 

  21. Goo TT, Goel R, Lawenko M, Lomanto D (2010) Laparoscopic transabdominal preperitoneal (TAPP) hernia repair via a single port. Surg Laparosc Endosc Percutan Tech 20:389–390

    Article  PubMed  Google Scholar 

  22. Huang CK, Lo CH, Houng JY, Chen YS, Lee PH (2010). Surgical results of single-incision transumbilical Roux-en-Y gastric bypass. Surg Obes Relat Dis 2010 Dec 25 (Epub ahead of print)

Download references

Conflict of interest

All authors declare that they have no competing interest and no relevant financial interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to R. Goel.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fuentes, M.B., Goel, R., Lee-Ong, A.C. et al. Single-port endo-laparoscopic surgery (SPES) for totally extraperitoneal inguinal hernia: a critical appraisal of the chopstick repair. Hernia 17, 217–221 (2013). https://doi.org/10.1007/s10029-012-0968-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10029-012-0968-4

Keywords

Navigation