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An Exploratory Randomized Controlled Trial Comparing Ultrasonic Dissection and Monopolar Electrocautery in
Yujiro Nakahara1, Kazuya Iwamoto1, Shohei Takaichi1
1Department of Gastroenterological Surgery, Osaka Keisatsu Hospital, Osaka, Japan.
Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|February 18, 2026
Summary
Monopolar electrocautery and ultrasonic dissection show similar surgical outcomes for single-incision laparoscopic totally extraperitoneal repair (SILS-TEP) in inguinal hernia repair. Further research is needed to confirm these findings for SILS-TEP procedures.
Area of Science:
- Minimally Invasive Surgery
- Surgical Technology
- Hernia Repair
Background:
- Inguinal hernia repair is a common surgical procedure.
- Single-incision laparoscopic totally extraperitoneal repair (SILS-TEP) offers potential benefits for patients.
- Comparing energy devices is crucial for optimizing SILS-TEP outcomes.
Purpose of the Study:
- To compare surgical outcomes of ultrasonic dissection versus monopolar electrocautery in SILS-TEP for inguinal hernias.
- To evaluate the feasibility and safety of both energy devices in this specific laparoscopic approach.
Main Methods:
- Exploratory randomized controlled trial with 62 patients undergoing SILS-TEP for unilateral inguinal hernias.
- Patients randomized to ultrasonic dissection (n=30) or monopolar electrocautery (n=32).
- Primary outcome: SILS-TEP completion rate. Secondary outcomes: intraoperative/postoperative complications, operative time, blood loss.
Main Results:
- Comparable SILS-TEP completion rates (96.7% vs. 96.9%).
- Similar operative times, blood loss, and complication rates between groups.
- Increased lens cleaning required with ultrasonic dissection (P=.025).
Conclusions:
- Monopolar electrocautery demonstrated comparable surgical outcomes to ultrasonic dissection in SILS-TEP.
- No significant differences in complications or operative efficiency were observed.
- Larger studies are recommended to validate these findings for SILS-TEP.
