Related Experiment Video
Updated: Feb 20, 2026
Application of Straight-needle, Three-tailed, Knot-free, Peritoneal Sutures in Laparoscopic Transabdominal Preperitoneal Hernia Repair
Published on: November 12, 2021
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.
Purpose:
This exploratory study aimed to compare the surgical outcomes of ultrasonic dissection and monopolar electrocautery in single-incision laparoscopic totally extraperitoneal repair (SILS-TEP) for inguinal hernia.
Methods:
A single-center exploratory randomized controlled trial was conducted between July 2022 and December 2023, enrolling 62 patients with unilateral inguinal hernias. Patients were randomized to undergo SILS-TEP using ultrasonic dissection (U group, n = 30) or monopolar electrocautery (E group, n = 32). The primary outcome was the completion rate of SILS-TEP. Secondary outcomes included the intraoperative complication rate, operative time, blood loss, and postoperative complication rate.
Results:
Patient characteristics were similar, except for a higher proportion of right-sided hernias in the U group (66.7% versus 31.3%, P = .010). Completion rates were comparable (96.7% versus 96.9%, P = 1.00). Operative time (60 [interquartile range {IQR} 53.5-71.5] minutes versus 62.5 [IQR: 51-74.5] minutes, P = .72) and blood loss were also similar. Lens cleaning was more frequently required in the U group (4 [IQR: 2.5-5] times versus 1 [IQR: 1-4] time, P = .025). Intraoperative and postoperative complications, length of postoperative hospital stay, and recurrence rates showed no notable differences.
Conclusion:
In this exploratory analysis, monopolar electrocautery in SILS-TEP showed comparable surgical outcomes to ultrasonic dissection. Larger confirmatory studies are warranted to validate these findings. (UMIN000057091).
