Skip to main content
Top
Published in: Hernia 4/2012

01-08-2012 | Original Article

Single-port hernia repair: a prospective cohort of 102 patients

Authors: Y. Soon, E. Yip, S. Onida, H. Mangat

Published in: Hernia | Issue 4/2012

Login to get access

Abstract

Background

Single-port laparoscopic surgery (SPLS) for totally extraperitoneal (TEP) groin hernia repair is a novel procedure, ensuring safe and effective repairs. The aim of this study was to assess the intra-operative and post-operative outcome for 102 patients undergoing SPLS TEP inguinal hernia repair at the Royal Surrey County Hospital in Guildford, UK. This follows on from our previously published series of 16 patients, demonstrating the safety and feasibility of SPLS in our cohort (Agrawal et al. in Surg Endosc 24:952–956, 2010).

Methods

Between October 2008 and August 2010, we performed hernia repairs on 102 patients (98 men, 4 women) aged between 21 and 89 years (median 60). Patient demographics, type of hernia, incision length, operating time, complications, post-operative hospital stay, and recurrence were collected prospectively. Post-operative outcome was measured in terms of days to return to normal activities, work, and analgesia required.

Results

Sixty patients had unilateral and 39 bilateral hernias, with 2 femoral hernias and one lipoma of cord. Operating time was 15–120 min (median 35 for unilateral and 45 for bilateral repairs). The incision length ranged between 15 and 40 mm (median 25). There was 1 intra-operative complication (major peritoneal incursion) and 13 minor post-operative complications, with 8 urinary retentions. There were no mortalities and one recurrence at follow-up (up to 713 days).

Conclusion

The authors’ experience has shown that SPLS TEP groin hernia repair is a feasible and safe alternative to three-port laparoscopic hernia repairs in a large patient cohort. There were minimal post-operative complications and good post-operative outcome. Recurrence rate was 0.98 %. Further studies are required to assess the long-term outcome of SPLS hernia repairs in direct comparison with three-port technique.
Literature
1.
go back to reference Agrawal S, Shaw A, Soon Y (2010) Single-port laparoscopic totally extraperitoneal inguinal hernia repair with the TriPort system: initial experience. Surg Endosc 24:952–956PubMedCrossRef Agrawal S, Shaw A, Soon Y (2010) Single-port laparoscopic totally extraperitoneal inguinal hernia repair with the TriPort system: initial experience. Surg Endosc 24:952–956PubMedCrossRef
2.
go back to reference Memon MA, Memon MA, Cooper NJ, Memon B, Memon MI, Abrams KR (2003) Metaanalysis of randomized clinical trials comparing open and laparoscopic inguinal hernia repair. Br J Surg 90:1479–1492PubMedCrossRef Memon MA, Memon MA, Cooper NJ, Memon B, Memon MI, Abrams KR (2003) Metaanalysis of randomized clinical trials comparing open and laparoscopic inguinal hernia repair. Br J Surg 90:1479–1492PubMedCrossRef
3.
go back to reference National Institute for Health and Clinical Excellence (2004) [Laparoscopic Surgery for Inguinal Hernia Repair]. [TAG83]. National Institute for Health and Clinical Excellence, London National Institute for Health and Clinical Excellence (2004) [Laparoscopic Surgery for Inguinal Hernia Repair]. [TAG83]. National Institute for Health and Clinical Excellence, London
4.
go back to reference Bucher P, Pugin F, Morel P (2009) Single port totally extraperitoneal laparoscopic inguinal hernia repair. Hernia 13:667–668PubMedCrossRef Bucher P, Pugin F, Morel P (2009) Single port totally extraperitoneal laparoscopic inguinal hernia repair. Hernia 13:667–668PubMedCrossRef
5.
go back to reference Filipovic-Cugura F, Kirac I, Kulis T, Jankovic J, Bekavac-Beslin M (2009) Single-incision laparoscopic surgery (SILS) for totally extraperitoneal (TEP) inguinal hernia repair: first case. Surg Endosc 23:920–921PubMedCrossRef Filipovic-Cugura F, Kirac I, Kulis T, Jankovic J, Bekavac-Beslin M (2009) Single-incision laparoscopic surgery (SILS) for totally extraperitoneal (TEP) inguinal hernia repair: first case. Surg Endosc 23:920–921PubMedCrossRef
6.
7.
go back to reference Piksun G, Rajpal S (1999) Transumbilical laparoscopic cholecystectomy utilizes no incisions outside the umbilicus. J Laparoendosc Adv Surg Tech A 9:361–364CrossRef Piksun G, Rajpal S (1999) Transumbilical laparoscopic cholecystectomy utilizes no incisions outside the umbilicus. J Laparoendosc Adv Surg Tech A 9:361–364CrossRef
8.
go back to reference Podolsky E, Mouhlas A, Wu AS, Poor A, Curcillo PG II (2010) Single Port Access (SPA™) laparoscopic ventral hernia repair: initial report of 30 cases. Surg Endosc 24:1557–1561PubMedCrossRef Podolsky E, Mouhlas A, Wu AS, Poor A, Curcillo PG II (2010) Single Port Access (SPA™) laparoscopic ventral hernia repair: initial report of 30 cases. Surg Endosc 24:1557–1561PubMedCrossRef
9.
go back to reference Saber A, Elgamal M, Itawi E, Rao A (2008) Single Incision Laparoscopic Sleeve Gastrectomy (SILS): a novel technique. Obes Surg 18:1338–1342PubMedCrossRef Saber A, Elgamal M, Itawi E, Rao A (2008) Single Incision Laparoscopic Sleeve Gastrectomy (SILS): a novel technique. Obes Surg 18:1338–1342PubMedCrossRef
10.
go back to reference Saber A, El-Ghazaly T (2009) Early experience with SILS port laparoscopic sleeve gastrectomy. Surg Laparosc Endosc Percutan Tech 19:428–430PubMedCrossRef Saber A, El-Ghazaly T (2009) Early experience with SILS port laparoscopic sleeve gastrectomy. Surg Laparosc Endosc Percutan Tech 19:428–430PubMedCrossRef
11.
go back to reference Brunner W, Schirnhofer J, Waldstein-Wartenberg N, Frass R, Weiss H (2010) Single incision laparoscopic sigmoid colon resections without visible scar: a novel technique. Colorectal Dis 12:66–70PubMedCrossRef Brunner W, Schirnhofer J, Waldstein-Wartenberg N, Frass R, Weiss H (2010) Single incision laparoscopic sigmoid colon resections without visible scar: a novel technique. Colorectal Dis 12:66–70PubMedCrossRef
12.
go back to reference Kim TJ, Lee YY, Chan HH, Kim CJ, Choi CH, Lee JW, Bae DK, Lee JH, Kim BG (2010) Single-port access laparoscopic-assisted vaginal hysterectomy versus conventional laparoscopic-assisted vaginal hysterectomy; a comparison of perioperative outcomes. Surg Endosc 24:2248–2252PubMedCrossRef Kim TJ, Lee YY, Chan HH, Kim CJ, Choi CH, Lee JW, Bae DK, Lee JH, Kim BG (2010) Single-port access laparoscopic-assisted vaginal hysterectomy versus conventional laparoscopic-assisted vaginal hysterectomy; a comparison of perioperative outcomes. Surg Endosc 24:2248–2252PubMedCrossRef
13.
go back to reference Targarona EM, Pallares JL, Balague C, Luppi CR, Marinello F, Hernandez P, Martinez C, Trias M (2010) Single incision approach for splenic diseases: a preliminary report on a series of 8 cases. Surg Endosc 24:2236–2240PubMedCrossRef Targarona EM, Pallares JL, Balague C, Luppi CR, Marinello F, Hernandez P, Martinez C, Trias M (2010) Single incision approach for splenic diseases: a preliminary report on a series of 8 cases. Surg Endosc 24:2236–2240PubMedCrossRef
14.
go back to reference Hirano D, Minei S, Yamaguchi K, Yoshikawa T, Hachiya T, Yoshida T, Ishida H, Takimoto Y, Saitoh T, Kiyotaki S, Okada K (2005) Retroperitoneoscopic adrenalectomy for adrenal tumors via a single large port. J Endourol 19:788–792PubMedCrossRef Hirano D, Minei S, Yamaguchi K, Yoshikawa T, Hachiya T, Yoshida T, Ishida H, Takimoto Y, Saitoh T, Kiyotaki S, Okada K (2005) Retroperitoneoscopic adrenalectomy for adrenal tumors via a single large port. J Endourol 19:788–792PubMedCrossRef
15.
go back to reference Jacob BP, Tong W, Reiner M, Vine A, Katz LB (2009) Single incision total extraperitoneal (one SUTE) laparoscopic inguinal hernia repair using a single access port device. Hernia 13:571–572PubMedCrossRef Jacob BP, Tong W, Reiner M, Vine A, Katz LB (2009) Single incision total extraperitoneal (one SUTE) laparoscopic inguinal hernia repair using a single access port device. Hernia 13:571–572PubMedCrossRef
16.
go back to reference Menenakos C, Kilian M, Hartmann J (2010) Single- port access in laparoscopic bilateral inguinal hernia repair: first clinical report of a novel technique. Hernia 14:309–312PubMedCrossRef Menenakos C, Kilian M, Hartmann J (2010) Single- port access in laparoscopic bilateral inguinal hernia repair: first clinical report of a novel technique. Hernia 14:309–312PubMedCrossRef
17.
go back to reference Wake BL, McCormack K, Fraser C, Vale L, Perez J, Grant A (2005) Transabdominal pre-peritoneal (TAPP) vs totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair. Cochrane Database of Systematic Reviews 1 Wake BL, McCormack K, Fraser C, Vale L, Perez J, Grant A (2005) Transabdominal pre-peritoneal (TAPP) vs totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair. Cochrane Database of Systematic Reviews 1
18.
go back to reference Grant AM, EU Hernia Trialists Collaboration (2002) Laparoscopic versus open groin hernia repair: meta-analysis of randomised trials based on individual patient data. Hernia 6:2–10PubMedCrossRef Grant AM, EU Hernia Trialists Collaboration (2002) Laparoscopic versus open groin hernia repair: meta-analysis of randomised trials based on individual patient data. Hernia 6:2–10PubMedCrossRef
19.
go back to reference EU Hernia Trialists Collaboration (2000) Laparoscopic compared with open methods of groin hernia repair: systematic review of randomized controlled trials. Br J Surg 87:860–867CrossRef EU Hernia Trialists Collaboration (2000) Laparoscopic compared with open methods of groin hernia repair: systematic review of randomized controlled trials. Br J Surg 87:860–867CrossRef
20.
go back to reference Rahman SH, John BJ (2010) Single- incision laparoscopic trans- abdominal pre- peritoneal mesh hernia repair: a feasible approach. Hernia 14:329–331PubMedCrossRef Rahman SH, John BJ (2010) Single- incision laparoscopic trans- abdominal pre- peritoneal mesh hernia repair: a feasible approach. Hernia 14:329–331PubMedCrossRef
Metadata
Title
Single-port hernia repair: a prospective cohort of 102 patients
Authors
Y. Soon
E. Yip
S. Onida
H. Mangat
Publication date
01-08-2012
Publisher
Springer-Verlag
Published in
Hernia / Issue 4/2012
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-012-0917-2

Other articles of this Issue 4/2012

Hernia 4/2012 Go to the issue