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Surgical Endoscopy
Published in: Surgical Endoscopy 1/2014

01-01-2014

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

Authors: F. Paul Buckley III, Hannah Vassaur, Sharon Monsivais, Nicole E. Sharp, Daniel Jupiter, Rob Watson, John Eckford

Published in: Surgical Endoscopy | Issue 1/2014

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Abstract

Background

Evidence in the literature regarding the potential of single-incision laparoscopic (SILS) inguinal herniorrhaphy currently is limited. A retrospective comparison of SILS and traditional multiport laparoscopic (MP) inguinal hernia repair was conducted to assess the safety and feasibility of the minimally invasive laparoscopic technique.

Methods

All laparoscopic inguinal hernia repairs performed by three surgeons at a single institution during 4 years were reviewed. Statistical evaluation included descriptive analysis of demographics including age, gender, body mass index (BMI), and hernia location (uni- or bilateral), in addition to bivariate and multivariate analyses of surgical technique and outcomes including operative times, conversions, and complications.

Results

The study compared 129 patients who underwent SILS inguinal hernia repair and 76 patients who underwent MP inguinal hernia repair. The cases included 190 men (92.68 %) with a mean age of 55.36 ± 18.01 years (range, 8–86 years) and a mean BMI of 26.49 ± 4.33 kg/m2 (range, 17.3–41.7 kg/m2). These variables did not differ significantly between the SILS and MP cohorts. The average operative times for the SILS and MP unilateral cases were respectively 57.51 and 66.96 min. For the bilateral cases, the average operative times were 81.07 min for SILS and 81.38 min for MP. A multivariate analysis using surgical approach, BMI, case complexity, and laterality as the covariates demonstrated noninferiority of the SILS technique in terms of operative time (p = 0.031). No conversions from SILS to MP occurred, and the rates of conversion to open procedure did not differ significantly between the cohorts (p = 1.00, Fisher’s exact test), nor did the complication rates (p = 0.65, χ 2).

Conclusions

As shown by the findings, SILS inguinal herniorrhaphy is a safe and feasible alternative to traditional MP inguinal hernia repair and can be performed successfully with similar operative times, conversion rates, and complication rates. Prospective trials are essential to confirm equivalence in these areas and to detect differences in patient-centered outcomes.
Literature
1.
Rutkow IM (1998) Epidemiologic, economic, and sociologic aspects of hernia surgery in the United States in the 1990s. Surg Clin North Am 78:941–951PubMedCrossRef
2.
Bittner R, Arregui ME, Bisgaard T, Dudai M, Ferzli GS, Fitzgibbons RJ, Fortelny RH, Klinge U, Kockerling F, Kuhry E, Kukleta J, Lomanto D, Misra MC, Montgomery A, Morales-Conde S, Reinpold W, Rosenberg J, Sauerland S, Schug-Pass C, Singh K, Timoney M, Weyhe D, Chowbey P (2011) Guidelines for laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal Hernia [International Endohernia Society (IEHS)]. Surg Endosc 25:2773–2843PubMedCentralPubMedCrossRef
3.
Neumayer L, Giobbie-Hurder A, Jonasson O, Fitzgibbons R Jr, Dunlop D, Gibbs J, Reda D, Henderson W (2004) Veterans Affairs Cooperative Studies Program 456 Investigators Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med 350:1819–1827PubMedCrossRef
4.
Liem MS, van der Graaf Y, van Steensel CJ, Boelhouwer RU, Clevers GJ, Meijer WS, Stassen LP, Vente JP, Weidema WF, Schrijvers AJ, van Vroonhoven TJ (1997) Comparison of conventional anterior surgery and laparoscopic surgery for inguinal-hernia repair. N Engl J Med 336:1541–1547PubMedCrossRef
5.
McCormack K, Wake B, Perez J, Fraser C, Cook J, McIntosh E, Vale L, Grant A (2005) Laparoscopic surgery for inguinal hernia repair: systematic review of effectiveness and economic evaluation. Health Technol Assess 9:1–203PubMed
6.
Ma J, Cassera MA, Spaun GO, Hammill CW, Hansen PD, Aliabadi-Wahle S (2011) Randomized controlled trail comparing single-port laparoscopic cholecystectomy and four-port laparoscopic cholecystectomy. Ann Surg 254:22–27PubMedCrossRef
7.
Markar SR, Karthikesalingam A, Thrumurthy S, Muirhead L, Kinross J, Paraskeva P (2012) Single-incision laparoscopic surgery (SILS) versus conventional multiport cholecystectomy: systematic review and meta-analysis. Surg Endosc 26:1205–1213PubMedCrossRef
8.
Champagne BJ, Papaconstantinou HT, Parmar SS, Nagle DA, Young-Fadok TM, Lee EC, Delaney CP (2012) Single-incision versus standard multiport laparoscopic colectomy: a multicenter, case-controlled comparison. Ann Surg 255:66–69PubMedCrossRef
9.
Bucher P, Pugin F, Buchs NC, Ostermann S, Morel P (2011) Randomized clinical trial of laparoendoscopic single-site versus conventional laparoscopic cholecystectomy. Br J Surg 98:1695–1702PubMedCrossRef
10.
St Peter SD, Adibe OO, Juang D, Sharp SW, Garey CL, Laituri CA, Murphy JP, Andrews WS, Sharp RJ, Snyder CL, Holcomb GW 3rd, Ostlie DJ (2011) Single-incision versus standard 3-port laparoscopic appendectomy. Ann Surg 254:586–590PubMedCrossRef
11.
Amos SE, Shuo-Dong W, Fan Y, Tian Y, Chen CC (2012) Single-incision versus conventional three-incision laparoscopic appendectomy: a single-centre experience. Surg Today 42:542–546PubMedCrossRef
12.
13.
14.
He K, Chen H, Ding R, Hua R, Yao Q (2011) Single-incision laparoscopic totally extraperitoneal inguinal hernia repair. Hernia 15:451–453PubMedCrossRef
15.
16.
Fuentes MB, Goel R, Lee-Ong AC, Cabrera EB, Lawenko M, Lopez-Gutierrez J, Lomanto D (2013) Single-port endolaparoscopic surgery (SPES) for totally extraperitoneal inguinal hernia: a critical appraisal of the chopstick repair. Hernia 17:217–221PubMedCrossRef
17.
Muensterer OJ, Keijzer R (2011) A simple vacuum dressing reduces the wound infection rate of single-incision pediatric endosurgical appendectomy. JSLS 15:147–150PubMedCentralPubMedCrossRef
18.
Tsimoyiannis EC, Tsimogiannis KE, Pappas-Gogos G, Farantos C, Benetatos N, Mavridou P, Manataki A (2010) Different pain scores in single transumbilical incision laparoscopic cholecystectomy versus classic laparoscopic cholecystectomy: a randomized controlled trial. Surg Endosc 24:1842–1848PubMedCrossRef
19.
20.
Marks J, Tacchino R, Roberts K, Onders R, Denoto G, Paraskeva P, Rivas H, Soper N, Rosemurgy A, Shah S (2011) Prospective randomized controlled trial of traditional laparoscopic cholecystectomy versus single-incision laparoscopic cholecystectomy: report of preliminary data. Am J Surg 201:369–373PubMedCrossRef
21.
Gill IS, Advincula AP, Aron M, Caddedu J, Canes D, Curcillo PG II, Desai MM, Evanko JC, Falcone T, Fazio V, Gettman M, Gumbs AA, Haber GP, Kaouk JH, Kim F, King SA, Ponsky J, Remzi F, Rivas H, Rosemurgy A, Ross S, Schauer P, Sotelo R, Speranza J, Sweeney J, Teixeira J (2010) Consensus statement of the consortium for laparoendoscopic single-site surgery. Surg Endosc 24:762–768PubMedCrossRef
22.
Sato H, Shimada M, Kurita N, Iwata T, Nishioka M, Morimoto S, Yoshikawa K, Miyatani T, Goto M, Kashihara H, Takasu C (2012) The safety and usefulness of the single-incision, transabdominal preperitoneal (TAPP) laparoscopic technique for inguinal hernia. J Med Invest 59:235–240PubMedCrossRef
Metadata
Title
Comparison of outcomes for single-incision laparoscopic inguinal herniorrhaphy and traditional three-port laparoscopic herniorrhaphy at a single institution
Authors
F. Paul Buckley III
Hannah Vassaur
Sharon Monsivais
Nicole E. Sharp
Daniel Jupiter
Rob Watson
John Eckford
Publication date
01-01-2014
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 1/2014
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-013-3145-7

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