Potential benefits of single-port compared to multiport laparoscopic inguinal herniorraphy: a prospective randomized controlled study

Abstract

Compared to multiport, single-port laparoscopic total extraperitoneal inguinal herniorraphy, when performed by a high-volume and highly dedicated hernia surgeon, resulted in significantly reduced postoperative pain, analgesic requirements, quicker return to work/normal activities, improved cosmesis, and equivalent safety and efficacy.

Single-incision laparoscopic inguinal herniorraphy with telescopic extraperitoneal dissection: technical aspects and potential benefits

“…In the field of hernia surgery, some specialized hernia centres have shown excellent safety and efficacy of SIL TEP repair. Our previous prospective randomized controlled study comparing singleport versus multiport TEP repair demonstrated unequivocal benefits of the single-port technique in terms of reducing post-op pain, analgesic requirements, earlier return to work or physical activities by 7 days and improved cosmetic scar scores [14]. Like any new invention, manufacturers need to recuperate Research and Development costs, and these single ports have remained relatively expensive compared to the conventional ports used for multiport surgery.…”

“…Post-operatively, patients were contacted by phone on day one for an assessment of their pain score and they were seen on day 7 to assess wound healing, hernia recurrence (early failure), visual analogue pain score and the total number of pain killers ingested. They were then seen 6 weeks after surgery to assess them for return to work or normal physical activities, recurrence, length of umbilical incision and cosmetic scar score [3(least satisfied)-24(most satisfied)] [14]. We plan to follow-up these patients on an annual basis for 5 years.…”

“…Compared to our previous RCT [14], where the original Triport TM (with gel valves) was used, the current study employed the Triport ? which has self-sealing silicone valves which minimized the risk of air leakage through the valves and allowed for ease of mesh placement, there were some disadvantages which needed to be overcome for safe and efficient operation (Fig.…”

“…In the field of hernia surgery, single incision laparoscopic (SIL) TEP inguinal herniorraphy, in prospective randomized controlled settings, has been reported to be safe [12], effective [13] with potential cosmetic and non-cosmetic benefits compared to multiport TEP repair (NCT01660048) [14]. However, this was achieved with additional costs of the single ports compared to those used in multiport surgery [14].…”

“…In the field of hernia surgery, single incision laparoscopic (SIL) TEP inguinal herniorraphy, in prospective randomized controlled settings, has been reported to be safe [12], effective [13] with potential cosmetic and non-cosmetic benefits compared to multiport TEP repair (NCT01660048) [14]. However, this was achieved with additional costs of the single ports compared to those used in multiport surgery [14]. Unlike multiport surgery where the recommended balloon dissection allows insertion of two additional 5-mm ports for performing the repair, single-port surgery allows safe insertion of the dissecting instruments at the outset, via the single port, into the extraperitoneal space, which can then be further dissected under direct vision.…”