Article
Transumbilical single-port laparoscopic transabdominal preperitoneal repair of inguinal hernia: Progress in reducing invasiveness
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Authors
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Bernhard Widmann
- Kantonsspital St. Gallen / Rorschach, Chirurgie Spital Rorschach, Rorschach
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Stephan Bischofberger
- Kantonsspital St. Gallen / Rorschach, Chirurgie Spital Rorschach, Rorschach
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Nabil Kalak
- Kantonsspital St. Gallen / Rorschach, Chirurgie Spital Rorschach, Rorschach
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Walter Brunner
- Kantonsspital St. Gallen / Rorschach, Chirurgie Spital Rorschach, Rorschach
| Published: | March 21, 2014 |
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Outline
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Introduction: Conventional laparoscopic repair of inguinal hernia usually requires 3 ports. Recently, single-port laparoscopic surgery techniques have been developed to further minimize surgical trauma to the abdominal wall and invasiveness compared to conventional laparoscopic surgery. We want to present our experience in single-port transabdominal preperitoneal (TAPP) repair of inguinal hernia.
Material and methods: This is a retrospective analysis from our prospectiv single-port database. All 232 patients undergoing transumbilical single-port TAPP between August 2011 and May 2013 at our hospital were included. Until now 101 Patients had a follow up phone survey to evaluate patient satisfaction and complications. Patients who described postoperative problems received a clinical examination.
Results: In 232 Patients (197 male and 35 female) 291 single-port TAPP procedures (173 unilateral, 59 bilateral, 14 recurrent hernia) were successfully performed. 19% had previous abdominal surgery. Mean operating time was 62.8 minutes for unilateral and 99.7 minutes for bilateral hernia repair. Mean fascial incision length was 23 mm (16-40 mm), median skin incision length was 30 mm (21-49 mm). In 8.6% additional trocars where needed, while there was no conversion to open surgery. There were no intraoperative complications. Early reoperation because of postoperative complication was necessary in 4 patients (1,7%). The follow up showed high satisfaction with the general result 1.3±0.65 (1 – very satisfied, 5 – very unsatisfied). Especially the satisfaction with the aesthetic result was very high 1.14±0.39. Up to now there was no incidence of a trocar hernia and one case of an inguinal hernia recurrence.
Conclusion: Single-port TAPP represents a safe and generally applicable surgery technique (even for the repair of recurrent hernia). The use of additional trocars is mainly due to improve patient safety. Moreover, it is nearly scarless and minimizes surgical trauma, leading to a high patient satisfaction.
