Single incision laparoscopic TAPP with standard laparoscopic instruments and suturing of flaps: A continuing study

Abstract

BACKGROUND:Single incision laparoscopic surgery, especially transumbilical, should be the closest to replicate the minimal access results achieved by natural orifice endoscopic surgery (NOTES). This study of single incision transabdominal preperitoneal (SITAPP) inguinal hernia repair is a continuing study exploring the peroperative variables and short and long term complications of this procedure.PATIENTS AND METHODS:All the 183 patients were operated by the same surgeon through a horizontal transumbilical incision positioned across the lower third of the umbilicus. Port access was through three separate transfacial punctures. Routine rigid instruments were used and the peritoneal flaps were either tacked or sutured into place. Patients with irreducible hernia and obstructed hernia were included, while those with strangulated hernia were excluded.RESULTS:All the patients were male with an average age of 41.4 years. Twenty four patients had bilateral hernia, 15 patients had irreducible and 6 patients had obstructed hernia. The mean operating time was 38.3 mins for unilateral hernias completed with tackers and 42.8 mins in those with intracorporeal suturing. The corresponding operating time for bilateral hernias was 53.2 and 62.7 minutes. There was minimal serous discharge from the umbilicus in 8 patients, port site infection in 1 patient and recurrence in 2 patients over a 36 months period.CONCLUSIONS:SITAPP for groin hernias, performed with conventional instruments is feasible, easy to learn, has a very high patient acceptance and is cosmetically superior to conventional TAPP. The use of tackers reduces the operating time significantly.

Needlescopic Surgery Versus Single-port Laparoscopy for Inguinal Hernia

“… 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.…”

Đánh Giá Kết Quả Sớm Phẫu Thuật Nội Soi Hoàn Toàn Ngả Trước Phúc Mạc, Sử Dụng Lưới 3d Điều Trị Thoát Vị Bẹn Tại Bệnh Viện E

“…độ đau sau phẫu thuật: dựa trên mô tả cảm giác đau của người bệnh, có tính toán đến nhu cầu dùng thuốc giảm đau để chia làm 5 mức độ theo VAS (Visual Analog Scale) bao gồm:Loại 1: Đau rất nhẹ, không yêu cầu dùng thuốc giảm đau.Loại 2: Đau nhẹ, cần dùng thuốc giảm đau dạng uống.Loại 3: Đau vừa, cần dùng thuốc giảm đau dạng tiêm loại không gây nghiện.Loại 4: Rất đau, cần dùng thuốc giảm đau dạng tiêm loại gây nghiện.Loại 5: Không chịu nổi, dù đã dùng thuốc giảm đau dạng tiêm loại gây nghiện.Đánh giá kết quả sớm: Dựa theo tiêu chuẩn của Sinha R 2. gồm 4 mức:+ Tốt: Không xuất hiện biến chứng sớm sau mổ.…”