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Published in: Hernia 6/2016

01-12-2016 | Original Article

Single-port versus conventional three-port laparoscopic totally extraperitoneal inguinal hernia repair: a randomized controlled trial

Authors: B. J. Choi, W. J. Jeong, I. K. Lee, S. C. Lee

Published in: Hernia | Issue 6/2016

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Abstract

Background

Single-port laparoscopic surgery (SPLS) has been introduced for totally extraperitoneal (TEP) inguinal hernia repair. Clinically, however, the benefits of single-port TEP (SP TEP) are unclear. This study aimed to compare short-term surgical outcomes between SP TEP and conventional laparoscopic TEP(CL TEP) inguinal hernia repair.

Methods

Between January 2013 and February 2015, 99 men with primary unilateral inguinal hernia were randomized to the single-port or conventional 3-port TEP procedures. The primary end point was postoperative pain. Secondary end points were complications, postoperative hospital stay, days to return to daily normal activities, cosmesis, and quality of life (QOL).

Results

We randomized 50 patients to SP TEP and 49 to CL TEP repair. The SP TEP group patients had significantly lower pain scores (visual analog scale) 7 days postoperation (p = 0.017). However, there were no significant differences between the two groups in postoperative pain scores 24 h (p = 0.44) and 4 weeks (p = 0.677) after operation and analgesic requirements on the operation day (p = 0.303) and 7 days after the operation (p = 0.204). Operation time, postoperative hospital stay, and complications were comparable between the two groups. The days to return to daily normal activities, QOL, and cosmetic satisfaction were not different between the two groups.

Conclusion

The outcomes of SP TEP hernia repair for operation time and morbidities were comparable to CL TEP, and postoperative pain was lower at 7 days than in CL TEP hernia repair. The SP TEP technique can be recommended as an alternative treatment for inguinal hernia repair in experienced hands.
Literature
1.
go back to reference Choi BJ, Lee KJ, Lee SC (2014) Direct application of single-port laparoscopic totally extraperitoneal (TEP) inguinal hernia repair by an experienced single-port laparoscopic surgeon who was inexperienced in conventional TEP hernia repair: initial experience with 100 cases. J Laparoendosc Adv Surg Tech A 24:333–338CrossRefPubMed Choi BJ, Lee KJ, Lee SC (2014) Direct application of single-port laparoscopic totally extraperitoneal (TEP) inguinal hernia repair by an experienced single-port laparoscopic surgeon who was inexperienced in conventional TEP hernia repair: initial experience with 100 cases. J Laparoendosc Adv Surg Tech A 24:333–338CrossRefPubMed
2.
go back to reference Memon MA, Cooper NJ, Memon B, Memon MI, Abrams KR (2003) Meta-analysis of randomized clinical trials comparing open and laparoscopic inguinal hernia repair. Br J Surg 90:1479–1492CrossRefPubMed Memon MA, Cooper NJ, Memon B, Memon MI, Abrams KR (2003) Meta-analysis of randomized clinical trials comparing open and laparoscopic inguinal hernia repair. Br J Surg 90:1479–1492CrossRefPubMed
3.
go back to reference Cugura JF, Kirac I, Kulis T, Sremac M, Ledinsky M, Beslin MB (2012) Comparison of single incision laparoscopic totally extraperitoneal and laparoscopic totally extraperitoneal inguinal hernia repair: initial experience. J Endourol 26:63–66CrossRefPubMed Cugura JF, Kirac I, Kulis T, Sremac M, Ledinsky M, Beslin MB (2012) Comparison of single incision laparoscopic totally extraperitoneal and laparoscopic totally extraperitoneal inguinal hernia repair: initial experience. J Endourol 26:63–66CrossRefPubMed
4.
go back to reference Kim JH, Lee YS, Kim JJ, Park SM (2013) Single port laparoscopic totally extraperitoneal hernioplasty: a comparative study of short-term outcome with conventional laparoscopic totally extraperitoneal hernioplasty. World J Surg 37:746–751CrossRefPubMed Kim JH, Lee YS, Kim JJ, Park SM (2013) Single port laparoscopic totally extraperitoneal hernioplasty: a comparative study of short-term outcome with conventional laparoscopic totally extraperitoneal hernioplasty. World J Surg 37:746–751CrossRefPubMed
5.
go back to reference Wakasugi M, Masuzawa T, Tei M, Omori T, Ueshima S, Tori M, Akamatsu H (2015) Single-incision totally extraperitoneal inguinal hernia repair: our initial 100 cases and comparison with conventional three-port laparoscopic totally extraperitoneal inguinal hernia repair. Surg Today 45:606–610CrossRefPubMed Wakasugi M, Masuzawa T, Tei M, Omori T, Ueshima S, Tori M, Akamatsu H (2015) Single-incision totally extraperitoneal inguinal hernia repair: our initial 100 cases and comparison with conventional three-port laparoscopic totally extraperitoneal inguinal hernia repair. Surg Today 45:606–610CrossRefPubMed
6.
go back to reference Yang GP, Tung KL (2015) A comparative study of single incision versus conventional laparoscopic inguinal hernia repair. Hernia 19:401–405CrossRefPubMed Yang GP, Tung KL (2015) A comparative study of single incision versus conventional laparoscopic inguinal hernia repair. Hernia 19:401–405CrossRefPubMed
7.
go back to reference de Araujo FB, Starling ES, Maricevich M, Tobias-Machado M (2014) Single site and conventional totally extraperitoneal techniques for uncomplicated inguinal hernia repair: a comparative study. J Minim Access Surg 10:197–201CrossRefPubMedPubMedCentral de Araujo FB, Starling ES, Maricevich M, Tobias-Machado M (2014) Single site and conventional totally extraperitoneal techniques for uncomplicated inguinal hernia repair: a comparative study. J Minim Access Surg 10:197–201CrossRefPubMedPubMedCentral
8.
go back to reference Tsai YC, Ho CH, Tai HC, Chung SD, Chueh SC (2013) Laparoendoscopic single-site versus conventional laparoscopic total extraperitoneal hernia repair: a prospective randomized clinical trial. Surg Endosc 27:4684–4692CrossRefPubMed Tsai YC, Ho CH, Tai HC, Chung SD, Chueh SC (2013) Laparoendoscopic single-site versus conventional laparoscopic total extraperitoneal hernia repair: a prospective randomized clinical trial. Surg Endosc 27:4684–4692CrossRefPubMed
9.
go back to reference Wijerathne S, Agarwal N, Ramzy A, Lomanto D (2014) A prospective randomized controlled trial to compare single-port endo-laparoscopic surgery versus conventional TEP inguinal hernia repair. Surg Endosc 28:3053–3058CrossRefPubMed Wijerathne S, Agarwal N, Ramzy A, Lomanto D (2014) A prospective randomized controlled trial to compare single-port endo-laparoscopic surgery versus conventional TEP inguinal hernia repair. Surg Endosc 28:3053–3058CrossRefPubMed
10.
go back to reference Tai HC, Lin CD, Chung SD, Chueh SC, Tsai YC, Yang SS (2011) A comparative study of standard versus laparoendoscopic single-site surgery (LESS) totally extraperitoneal (TEP) inguinal hernia repair. Surg Endosc 25:2879–2883CrossRefPubMed Tai HC, Lin CD, Chung SD, Chueh SC, Tsai YC, Yang SS (2011) A comparative study of standard versus laparoendoscopic single-site surgery (LESS) totally extraperitoneal (TEP) inguinal hernia repair. Surg Endosc 25:2879–2883CrossRefPubMed
11.
go back to reference Langeveld HR, van’t Riet M, Weidema WF, Stassen LP, Steyerberg EW, Lange J, Bonjer HJ, Jeekel J (2010) Total extraperitoneal inguinal hernia repair compared with Lichtenstein (the LEVEL-Trial): a randomized controlled trial. Ann Surg 251:819–824CrossRefPubMed Langeveld HR, van’t Riet M, Weidema WF, Stassen LP, Steyerberg EW, Lange J, Bonjer HJ, Jeekel J (2010) Total extraperitoneal inguinal hernia repair compared with Lichtenstein (the LEVEL-Trial): a randomized controlled trial. Ann Surg 251:819–824CrossRefPubMed
12.
go back to reference Belyansky I, Tsirline VB, Klima DA, Walters AL, Lincourt AE, Heniford TB (2011) Prospective, comparative study of postoperative quality of life in TEP, TAPP, and modified Lichtenstein repairs. Ann Surg 254:709–714 (discussion 714–705) CrossRefPubMed Belyansky I, Tsirline VB, Klima DA, Walters AL, Lincourt AE, Heniford TB (2011) Prospective, comparative study of postoperative quality of life in TEP, TAPP, and modified Lichtenstein repairs. Ann Surg 254:709–714 (discussion 714–705) CrossRefPubMed
13.
go back to reference Myers E, Browne KM, Kavanagh DO, Hurley M (2010) Laparoscopic (TEP) versus Lichtenstein inguinal hernia repair: a comparison of quality-of-life outcomes. World J Surg 34:3059–3064CrossRefPubMed Myers E, Browne KM, Kavanagh DO, Hurley M (2010) Laparoscopic (TEP) versus Lichtenstein inguinal hernia repair: a comparison of quality-of-life outcomes. World J Surg 34:3059–3064CrossRefPubMed
14.
go back to reference Jacob BP, Tong W, Reiner M, Vine A, Katz LB (2009) Single incision total extraperitoneal (one SITE) laparoscopic inguinal hernia repair using a single access port device. Hernia 13:571–572CrossRefPubMed Jacob BP, Tong W, Reiner M, Vine A, Katz LB (2009) Single incision total extraperitoneal (one SITE) laparoscopic inguinal hernia repair using a single access port device. Hernia 13:571–572CrossRefPubMed
15.
17.
go back to reference Kim JH, An CH, Lee YS, Kim HY, Lee JI (2015) Single incision laparoscopic totally extraperitoneal hernioplasty (SIL-TEP): experience of 512 procedures. Hernia 19:417–422CrossRefPubMed Kim JH, An CH, Lee YS, Kim HY, Lee JI (2015) Single incision laparoscopic totally extraperitoneal hernioplasty (SIL-TEP): experience of 512 procedures. Hernia 19:417–422CrossRefPubMed
18.
go back to reference Siddiqui MR, Kovzel M, Brennan SJ, Priest OH, Preston SR, Soon Y (2014) The role of the laparoendoscopic single site totally extraperitoneal approach to inguinal hernia repairs: a review and meta-analysis of the literature. Can J Surg 57:116–126CrossRefPubMedPubMedCentral Siddiqui MR, Kovzel M, Brennan SJ, Priest OH, Preston SR, Soon Y (2014) The role of the laparoendoscopic single site totally extraperitoneal approach to inguinal hernia repairs: a review and meta-analysis of the literature. Can J Surg 57:116–126CrossRefPubMedPubMedCentral
19.
go back to reference Ma J, Cassera MA, Spaun GO, Hammill CW, Hansen PD, Aliabadi-Wahle S (2011) Randomized controlled trial comparing single-port laparoscopic cholecystectomy and four-port laparoscopic cholecystectomy. Ann Surg 254:22–27CrossRefPubMed Ma J, Cassera MA, Spaun GO, Hammill CW, Hansen PD, Aliabadi-Wahle S (2011) Randomized controlled trial comparing single-port laparoscopic cholecystectomy and four-port laparoscopic cholecystectomy. Ann Surg 254:22–27CrossRefPubMed
Metadata
Title
Single-port versus conventional three-port laparoscopic totally extraperitoneal inguinal hernia repair: a randomized controlled trial
Authors
B. J. Choi
W. J. Jeong
I. K. Lee
S. C. Lee
Publication date
01-12-2016
Publisher
Springer Paris
Published in
Hernia / Issue 6/2016
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-016-1499-1

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