Comparison of outcomes for single-incision laparoscopic inguinal herniorrhaphy and traditional three-port laparoscopic herniorrhaphy at a single institution

Buckley, F. Paul; Vassaur, Hannah; Monsivais, Sharon; Sharp, Nicole E.; Jupiter, Daniel C.; Watson, Rob; Eckford, John

doi:10.1007/s00464-013-3145-7

Cited by 31 publications

(33 citation statements)

References 22 publications

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“…The 2014 study by Lai et al incorporated eight clinical trials—two on percutaneous extraperitoneal closure (PEC) , one on TAPP , and five on TEP —in its quantitative analysis; the eight trials had a total of 926 patients . A study by Luo et al published in 2017 included 17 clinical trials—2 on PEC , 2 on TAPP , and 13 on TEP —in its quantitative analysis; the 17 trials had a total of 1737 patients . The 2016 study by Sajid et al incorporated 15 trials—2 on PEC , 1 on TAPP , 11 on TEP , and 1 with combined results from TAPP and TEP —in its quantitative analysis; the 15 trials had a total of 1651 patients .…”

Section: Current Evidencementioning

confidence: 99%

“…The 2014 study by Siddiqui et al included three studies that analyzed a total of 287 patients (LESS, 128; conventional, 159) . The 2016 study by Lo et al included seven additional studies, for a total of 10, in its quantitative analysis ; these studies included four RCT, three prospective studies, and three retrospective studies, with a total of 1109 patients (LESS TEP, 595; conventional TEP, 514). The study by Lo et al found unilateral LESS TEP took significantly longer than conventional TEP ( P = 0.02); there was no significant heterogeneity of data from the studies used.…”

Section: Current Evidencementioning

confidence: 99%

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Laparoendoscopic single‐site surgery in inguinal hernia repair

Buenafe

Lee-Ong

2017

Asian J Endoscop Surgery

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Laparoendoscopic single-site surgery (LESS) for laparoscopic inguinal hernia repair (IHR) offers the potential for excellent cosmetic outcomes and maximization of the inherent advantages of minimally invasive surgery. LESS IHR is associated with a steep learning curve, which is attributable to both the IHR technique itself and the single-site technique. The technical obstacles in the single-site technique may be mitigated by employing certain maneuvers and strategies that minimize clashing between instruments and improve freedom of movement. The current literature consistently points out the inherent challenges in LESS IHR, with its longer operative time compared to that of conventional laparoscopic IHR. LESS IHR performed by capable operators has comparable complication rates, duration of hospital stay, and incidence of recurrence as conventional laparoscopic IHR. LESS IHR is both feasible and safe. Given its excellent cosmetic outcome, it is likely to be sought by younger patients who are concerned with scar formation. The use of robotics may bypass the technical challenges in LESS, but cost considerations in their usage will likely persist.

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Section: Current Evidencementioning

confidence: 99%

Section: Current Evidencementioning

confidence: 99%

Laparoendoscopic single‐site surgery in inguinal hernia repair

Buenafe

Lee-Ong

2017

Asian J Endoscop Surgery

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“… 5 , 6 Also TAPP repairs in single-incision laparoscopic surgery (sTAPP), with a reduction in the number of ports to only 1 umbilical port, have been put forward with good initial results. 7 , 8 However, a direct comparison between these 2 advanced minimally invasive approaches is still missing. The purpose of this study was to compare the perioperative extent of surgical trauma and its postoperative impact on the abdominal wall after nTAPP and sTAPP repair.…”

Section: Introductionmentioning

confidence: 99%

Needlescopic Surgery Versus Single-port Laparoscopy for Inguinal Hernia

Chan¹,

Hollinsky²

2015

JSLS

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Background and Objectives:In recent years, 2 modifications of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair—needlescopic (nTAPP) surgery and single-port (sTAPP) surgery—have greatly improved patient outcomes over traditional approaches. For a comparison of these 2 modifications, we sought to investigate and compare the extent of surgical trauma and postoperative consequences for the abdominal wall in these two procedures.Methods:In a retrospective study, 50 nTAPP and 35 sTAPP procedures occurring at a community hospital from November 1, 2009, through July 31, 2012 were reviewed. Intraoperative data, including length of the umbilical skin incision and operative time, were recorded. A follow-up evaluation included investigation of hernia recurrence, postoperative pain, abdominal wall mobility, cosmetic satisfaction, and period of sick leave.Results:The mean umbilical skin incision was 13 ± 4 mm in nTAPP vs 27 ± 3 mm in sTAPP (P < .001). The nTAPP procedure required less operating time than the sTAPP procedure (54.8 ± 16.9 minutes vs 85.9 ± 19.7 minutes; P < .001). The mean immediate postoperative pain score on the visual analog scale was 2.7 ± 2.1 in the nTAPP group and 4.4 ± 1.9 in the sTAPP group (P = .016). In addition, patients who underwent nTAPP had a shorter period of sick leave (11.2 ± 8.4 days vs 24.1 ± 20.1 days; P = .02). At the follow-up evaluation after approximately 30 months, abdominal wall mobility and cosmetic satisfaction were equally positive, with no hernia recurrence.Conclusion:In patients with uncomplicated inguinal hernia, the nTAPP procedure, with less surgical trauma and operating time, has distinct advantages in reduction of immediate postoperative pain and sick leave time.

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“…Prospective randomized controlled trials (RCTs), mainly for cholecystectomy 13 , 14 and appendectomy 15 and mostly with small samples of patients, but more significantly, comparisons during of the learning curve of single-port and multiport surgery, have shown the single-port approach to be consistently safe and effective, as has single-port laparoscopic inguinal herniorrhaphy. 16 – 18 However, data regarding the superiority of single-port over conventional multiport procedures, other than cosmesis, 19 are still lacking, although it is hoped that with increasing experience with SIL, more high-powered RCTs will provide us with a clearer picture of the place of SIL in surgical approaches.…”

Section: Introductionmentioning

confidence: 99%

Single-Port Onlay Mesh Repair of Recurrent Inguinal Hernias after Failed Anterior and Laparoscopic Repairs

Tran

Zajkowska

et al. 2015

JSLS

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Background and Objectives:Despite the exponential increase in the use of laparoscopic inguinal herniorrhaphy, overall recurrence rates have remained unchanged. Therefore, a growing number of patients are presenting with recurrent hernias after conventional anterior and laparoscopic repairs have failed. This study reports our experience with single-incision laparoscopic (SIL) intraperitoneal onlay mesh (IPOM) repair of these hernias.Methods:Patients referred with two or more recurrences of inguinal hernia underwent SIL-IPOM from November 1, 2009, to June 24, 2014. A 2.5-cm infraumbilical incision was made, and an SIL port was placed intraperitoneally. Modified dissection techniques were used: chopstick and inline dissection, 5.5-mm/52-cm/30° angled laparoscope, and conventional straight dissecting instruments. The peritoneum was incised above the pubic symphysis, and dissection was continued laterally and proximally, raising the inferior flap below the previous extraperitoneal mesh while reducing any direct, indirect, femoral, or cord lipoma before placement of antiadhesive mesh, which was fixed to the pubic ramus, as well as superiorly, with nonabsorbable tacks before the inferior border was fixed with fibrin sealant. The inferior peritoneal flap was then tacked back onto the mesh.Results:Nine male patients underwent SIL-IPOM. Their mean age was 53 years and mean body mass index was 26.8 kg/m2. Mean mesh size was 275 cm2. Mean operation time was 125 minutes, with a hospital stay of 1 day. The umbilical scar length was 23 mm at the 6-week follow-up. There were no intra-/postoperative complications, port-site hernias, chronic groin pain, or recurrence of the hernia during a mean follow-up of 24 months.Conclusion:Inguinal hernias recurring after two or more failed conventional anterior and laparoscopic repairs can be safely and efficiently treated with SIL-IPOM.

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Comparison of outcomes for single-incision laparoscopic inguinal herniorrhaphy and traditional three-port laparoscopic herniorrhaphy at a single institution

Cited by 31 publications

References 22 publications

Laparoendoscopic single‐site surgery in inguinal hernia repair

Laparoendoscopic single‐site surgery in inguinal hernia repair

Needlescopic Surgery Versus Single-port Laparoscopy for Inguinal Hernia

Single-Port Onlay Mesh Repair of Recurrent Inguinal Hernias after Failed Anterior and Laparoscopic Repairs

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