Comparison of advanced bipolar versus conventional monopolar energy device in single incision laparoscopic total...

Single-incision laparoscopic totally extraperitoneal hernia repair (SILTEP) is a minimally invasive technique for inguinal hernia that promotes faster recovery. Advanced bipolar (AB) energy devices have recently emerged, offering several benefits in surgical outcomes. This study aimed to compare AB and conventional monopolar (CM) energy devices to assess their impact on surgical outcomes in SILTEP and to evaluate the necessity of using AB devices.

A retrospective comparative analysis was conducted involving 304 patients who underwent SILTEP, divided into the CM and AB groups based on the energy device used. Patient characteristics, operative details, and postoperative outcomes were compared between the groups.

The AB group exhibited longer operation times but similar morbidity rates compared to the CM group (53.5 ± 21.0 minutes vs. 42.9 ± 14.5 minutes, P < 0.001; 8.1% vs. 11.2%, P = 0.618). There was a significant difference in intraoperative blood loss (CM group: 7.2 ± 4.1 mL vs. AB group: 3.3 ± 5.0 mL, P < 0.001). Although statistically non-significant, a lower trend of seroma formation was observed in the AB group than in the CM group (7.4% vs. 10.7%). Similar early postoperative pain scores were observed in both groups of patients using patient-controlled analgesia; no significant differences in chronic pain were observed between the groups.

AB energy devices may offer advantages for SILTEP, including reduced intraoperative blood loss. AB energy devices may be useful and viable options for SILTEP. Further prospective studies are warranted to validate these findings.