Evaluation of single-incision laparoscopic totally extra-peritoneal hernia repair by self-made path in adults with inguinal hernia

doi:10.3877/cma.j.issn.1674-392X.2022.06.015

Abstract

Abstract:

Objective

Using sterile gloves and incision protector, a single-hole laparoscopic path was developed to perform adult laparoscopic inguinal hernia repair. To assess the safety, efficacy and complications of self-made path single-incision laparoscopic totally extra-peritoneal hernia repair (SIL-TEP) compared with conventional multiple-port laparoscopic totally extra-peritoneal hernia repair (MP-TEP).

Methods

We enrolled 160 patients with inguinal hernia who underwent unilateral or bilateral TEP in the Department of Gastrointestinal Surgery of the Fifth Affiliated Hospital of Sun Yat Sen University from July 2017 to March 2019. Eighty patients underwent self-made path SIL-TEP, and 80 patients underwent MP-TEP. The operation time, complications and visual analogue pain scale (VAS) were compared between the two groups.

Results

There were no significant differences in mean operation time between the SIL-TEP and MP-TEP groups [(86.06±33.69) min vs (89.36±36.30) min, P>0.05]. The postoperative 2 h VAS scores of SIL-TEP group was significantly lower than MP-TEP group [(1.89±0.84) vs (2.36±1.25), P=0.005], but postoperative 24 h VAS scores did not differ significantly between the two groups [(1.55±0.50) vs (1.63±0.48), P>0.05). The incidence of postoperative complications was similar between the SIL-TEP (23.8%) and MP-TEP groups (26.3%), P>0.05. We saw no recurrence at least 6-month follow-up in SIL-TEP group, and 2 recurrence in MP-TEP group.

Conclusion

Compared with MP-TEP, SIL-TEP had fewer incisions, milder postoperative pain scores, no severe complications, and similar operation time.

Key words: Hernia, inguinal, Laparoscopes, Herniorrhaphy, Single-incision

Xiao Wang, Yonghui Su, Baimeng Zhang, Xingwei Liu. Evaluation of single-incision laparoscopic totally extra-peritoneal hernia repair by self-made path in adults with inguinal hernia[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2022, 16(06): 677-681.

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Figures/Tables 6

References 20

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组别	例数	性别		年龄(岁,±s)	病程(月,±s)	体质量指数(kg/m²,±s)	既往病史
组别	例数	男	女	年龄(岁,±s)	病程(月,±s)	体质量指数(kg/m²,±s)	慢性咳嗽	便秘	前列腺肥大	腹水	糖尿病	高血压	下腹部手术史
单孔组	80	77(96.3)	3(3.8)	50.8±13.5	39.18±9.87	23.46±3.04	5(6.3)	2(2.5)	6(7.5)	2(2.5)	4(5.0)	19(23.8)	15(18.8)
三孔组	80	77(96.3)	3(3.8)	53.5±15.6	28.08±7.76	22.82±3.16	6(7.5)	6(7.5)	6(7.5)	1(1.3)	3(3.8)	10(12.5)	15(18.8)
t/χ²值		0.000	0.000	-1.184	0.880	1.417	0.098	2.092	0.000	0.338	0.148	3.411	0.000
P值		1.000	1.000	0.238	0.380	0.159	0.755	0.148	1.000	0.561	0.700	0.065	1.000
组别	例数	疝分类					疝部位
组别	例数	斜疝	直疝	复合疝	阴囊疝	复发疝	右侧	左侧	双侧
单孔组	80	53(66.3)	8(10.0)	19(23.8)	33(41.3)	5(6.3)	41(51.3)	20(25.0)	19(23.8)
三孔组	80	58(72.5)	7(8.8)	15(18.8)	28(35.0)	4(5.0)	43(53.8)	26(32.5)	11(13.8)
t/χ²值		0.735	0.074	0.598	0.662	0.118	0.100	1.098	2.626
P值		0.391	0.786	0.440	0.416	0.732	0.752	0.295	0.105

组别	例数	性别		年龄(岁,±s)	病程(月,±s)	体质量指数(kg/m²,±s)	既往病史
组别	例数	男	女	年龄(岁,±s)	病程(月,±s)	体质量指数(kg/m²,±s)	慢性咳嗽	便秘	前列腺肥大	腹水	糖尿病	高血压	下腹部手术史
单孔组	80	77(96.3)	3(3.8)	50.8±13.5	39.18±9.87	23.46±3.04	5(6.3)	2(2.5)	6(7.5)	2(2.5)	4(5.0)	19(23.8)	15(18.8)
三孔组	80	77(96.3)	3(3.8)	53.5±15.6	28.08±7.76	22.82±3.16	6(7.5)	6(7.5)	6(7.5)	1(1.3)	3(3.8)	10(12.5)	15(18.8)
t/χ²值		0.000	0.000	-1.184	0.880	1.417	0.098	2.092	0.000	0.338	0.148	3.411	0.000
P值		1.000	1.000	0.238	0.380	0.159	0.755	0.148	1.000	0.561	0.700	0.065	1.000
组别	例数	疝分类					疝部位
组别	例数	斜疝	直疝	复合疝	阴囊疝	复发疝	右侧	左侧	双侧
单孔组	80	53(66.3)	8(10.0)	19(23.8)	33(41.3)	5(6.3)	41(51.3)	20(25.0)	19(23.8)
三孔组	80	58(72.5)	7(8.8)	15(18.8)	28(35.0)	4(5.0)	43(53.8)	26(32.5)	11(13.8)
t/χ²值		0.735	0.074	0.598	0.662	0.118	0.100	1.098	2.626
P值		0.391	0.786	0.440	0.416	0.732	0.752	0.295	0.105

组别	例数	手术出血量(ml)	手术时间(min)	中转手术[例(%)]	术后视觉模拟量表评分		术后住院时间(d)	总住院时间(d)
组别	例数	手术出血量(ml)	手术时间(min)	中转手术[例(%)]	2 h	24 h	术后住院时间(d)	总住院时间(d)
单孔组	80	10.81±6.52	86.06±33.69	2(2.5)	1.89±0.84	1.55±0.50	1.48±0.69	3.53±1.64
三孔组	80	10.05±6.08	89.36±36.30	5(6.3)	2.36±1.25	1.63±0.48	2.96±1.71	5.51±2.39
t/χ²值		0.764	-0.439	1.336	-2.827	-0.960	-7.212	-6.114
P值		0.446	0.552	0.248	0.005	0.338	<0.01	<0.01

组别	例数	手术出血量(ml)	手术时间(min)	中转手术[例(%)]	术后视觉模拟量表评分		术后住院时间(d)	总住院时间(d)
组别	例数	手术出血量(ml)	手术时间(min)	中转手术[例(%)]	2 h	24 h	术后住院时间(d)	总住院时间(d)
单孔组	80	10.81±6.52	86.06±33.69	2(2.5)	1.89±0.84	1.55±0.50	1.48±0.69	3.53±1.64
三孔组	80	10.05±6.08	89.36±36.30	5(6.3)	2.36±1.25	1.63±0.48	2.96±1.71	5.51±2.39
t/χ²值		0.764	-0.439	1.336	-2.827	-0.960	-7.212	-6.114
P值		0.446	0.552	0.248	0.005	0.338	<0.01	<0.01

组别	例数	复发	血肿	阴囊水肿	血清肿	切口液化	肠梗阻	慢性疼痛	补片感染	总并发症
单孔组	80	0	1(1.3)	4(5.0)	13(16.3)	1(1.3)	0	0	0	19(23.8)
三孔组	80	2(2.5)	6(7.5)	4(5.0)	9(11.3)	1(1.3)	1(1.3)	0	0	21(26.3)
χ²值		2.013	1.943	0.000	0.915	0.000	1.000	0.000	0.000	0.133
P值		0.156	0.054	1.000	0.362	1.000	0.320	1.000	1.000	0.715

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