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Gasless single-incision laparoscopic inguinal hernia repair: initial experience.
1Department of Surgery, Caritas Medical Centre, 111 Wing Hong Street, Sham Shui Po, Kowloon, Hong Kong, People's Republic of China.
Hernia : the Journal of Hernias and Abdominal Wall Surgery
|August 16, 2017
Summary
Gasless single-incision laparoscopic inguinal hernia repair using the totally extraperitoneal (TEP) approach is feasible and safe. This minimally invasive technique offers rapid recovery, even for high-risk patients, and shows no recurrence in follow-up.
Area of Science:
- Minimally Invasive Surgery
- Hernia Repair
- Surgical Innovation
Background:
- Laparoscopic hernioplasty offers rapid recovery, with single-incision surgery emerging as an advancement.
- Traditional laparoscopic surgery using carbon dioxide insufflation is unsuitable for patients with cardiovascular or pulmonary conditions.
- Gasless techniques overcome insufflation limitations, expanding minimally invasive options.
Purpose of the Study:
- To report the early experience with gasless single-incision laparoscopic inguinal hernia repair using a totally extraperitoneal (TEP) approach.
- To evaluate the feasibility and outcomes of this technique, particularly in patients with cardiorespiratory compromise.
Main Methods:
- Prospective analysis of 15 consecutive patients undergoing gasless single-incision laparoscopic inguinal hernia repair (2010-2012) by a single surgeon.
- Utilized an abdominal wall lifting technique with a self-tailored device.
- Collected data on patient demographics, hernia characteristics, operative findings, and postoperative outcomes.
Main Results:
- All 15 patients had unilateral hernias; two presented with incarceration, one requiring bowel resection.
- No conversions to open surgery or additional ports were needed. Median operating times were 80 min (elective) and 178 min (emergency).
- Median hospital stay was 1 day, with minimal analgesic requirement and rapid return to normal activity (median 2 days). No major complications or mesh infections occurred; one hematoma was managed successfully. Median follow-up of 54 months showed no recurrence.
Conclusions:
- Gasless single-incision TEP is a feasible and effective technique for inguinal hernia repair, yielding favorable outcomes.
- The technique is suitable for high-risk patients with compromised cardiorespiratory status and can be applied in emergency settings for incarcerated hernias.
- Further large-scale randomized studies are warranted to validate the effectiveness of this innovative approach.
