To compare operative outcomes, safety, and feasibility between single-incision (SIL-) and three-port totally extraperitoneal(TEP) inguinal hernia repair.

This was a retrospective cohort study. We retrospectively analyzed the clinical data of 160 adult patients who underwent SIL-TEP or TEP inguinal hernia repair in the Hernia Surgery Group of Putuo Hospital Affiliated with Shanghai University of Traditional Chinese Medicine from December 2020 to December 2023. The patients were divided into the SIL-TEP group (n=80) and the TEP group (n=80) according to the surgical approach. The operative time, postoperative hospital stay, Visual Analogue Scale (VAS) pain scores at 24 h and 48 h postoperatively, the incidence of complications (including seroma, subcutaneous hematoma, wound infection, mesh infection, and recurrence), and patient satisfaction were compared between the two groups.

There were no statistically significant differences between the two groups in terms of postoperative hospital stay, VAS pain scores at 48 hours postoperatively, or the overall incidence of postoperative complications (P>0.05). Compared with the TEP group, the SIL-TEP group had a longer operative time and lower VAS pain scores at 24 hours postoperatively, with both differences being statistically significant (P<0.05). The surgical satisfaction and incision satisfaction scores in the SIL-TEP group were higher than those in the three-port TEP group, and the difference in incision satisfaction scores between the two groups was statistically significant (P<0.05).

SIL-TEP and TEP demonstrate comparable efficacy and safety; however, SIL-TEP is associated with lower VAS pain scores at 24 hours postoperatively and higher patient satisfaction.