Single-incision laparoscopic transabdominal preperitoneal hernioplasty: 1,054 procedures and experience.

Publisher: Springer Country of Publication: France NLM ID: 9715168 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1248-9204 (Electronic) Linking ISSN: 12489204 NLM ISO Abbreviation: Hernia Subsets: MEDLINE

Original Publication: Paris, France : Springer, c1997-

Hernia, Inguinal*/surgery ; Hernia, Inguinal*/etiology ; Laparoscopy*/adverse effects ; Laparoscopy*/methods ; Abdominal Injuries*/surgery; Humans ; Herniorrhaphy/methods ; Retrospective Studies ; Treatment Outcome ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/surgery ; Surgical Mesh ; Recurrence

Purpose: Although there have been numerous studies on single-incision laparoscopic inguinal hernia repair (SIL-IHR), the short- and long-term outcomes in patients from a large single institution who underwent single-incision laparoscopic transabdominal preperitoneal hernioplasty (SIL-TAPP) have rarely been reported. The purpose of this study is to evaluate the short- and long-term outcomes of SIL-TAPP and its safety and feasibility in patients from a large single institution.
Methods: The details of 1,054 procedures in 966 patients who underwent SIL-TAPP at the Affiliated Hospital of Nantong University from January 2015 to October 2022 were retrospectively analysed. SIL-TAPP was performed completely through the umbilicus using conventional laparoscopic instruments. Short-term and long-term outcomes of SIL-TAPP were collected by outpatient and telephone follow-ups. In addition, we further compared the operation time, length of postoperative hospital stay, and postoperative complications of patients with simple and complicated unilateral inguinal hernias.
Results: A total of 1,054 procedures were performed for 878 unilateral inguinal hernias and 88 bilateral inguinal hernias. In total, there were 803 (76.2%) indirect inguinal hernias, 192 (18.2%) direct inguinal hernias, 51 (4.8%) femoral hernias and 8 (0.8%) combined hernias. The mean operative time was 35.5 ± 17.0 min for unilateral inguinal hernias and 51.9 ± 25.5 min for bilateral inguinal hernias. There was one (0.1%) conversion to two-incision laparoscopic transabdominal preperitoneal hernioplasty. No intraoperative haemorrhages, inferior epigastric vessel injury or nerve damage occurred. Postoperative complications were minor and could be resolved without surgical intervention. The mean length of hospital stay was 1.3 ± 0.8 days. The median follow-up was 44 months, no trocar hernia occurred, and there was one (0.1%) recurrence. The operation time in the complicated inguinal hernia group was significantly higher than that in the simple inguinal hernia group (38.9 ± 22.3 vs. 35.0 ± 15.6, p = 0.025). The length of postoperative hospital stay and complication rate of the complicated inguinal hernia group were slightly higher than those of the simple inguinal hernia group, but the difference was not statistically significant.
Conclusion: SIL-TAPP is safe and technically feasible, and both short- and long-term outcomes are acceptable.
(© 2023. The Author(s).)

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Keywords: Groin hernia; Hernioplasty; Inguinal hernia; Single-incision laparoscopic surgery; TAPP

Date Created: 20230528 Date Completed: 20230928 Latest Revision: 20231004

20231215

PMC10533582

10.1007/s10029-023-02803-1

37245176