To introduce the clinical advantages of MiniLap assisted double ports laparoscopic totally extraperitoneal inguinal hernia repair (MaDP TEP).

A retrospective analysis of the clinical data of 10 patients who underwent MaDP TEP from June to October 2022 at the Hernia and Abdominal Wall Surgery Unit of the Center for Digestive Disease, the Seventh Affiliated Hospital of Sun Yat-sen University were performed. The procedure involved a 10mm laparoscopic trocar, a 5mm working trocar, and the MiniLap, referring to the layout of the traditional three-trocar totally extraperitoneal inguinal hernia repair (TEP). The MiniLap was inserted into the operative area through a 1mm skin incision without the need for a linear incision. The general data of the patients were analyzed, and postoperative outcomes were recorded, including day 1 postoperative Numerical Rating Scale (NRS) pain scores, infection rates at the surgical site, hernia recurrence rates, 3-week scar scores at the two trocar sites and the MiniLap site using the SCAR scale, and unilateral hernia dissection operation time (excluding the time for mesh placement).

Among the 10 patients, there were 9 males and 1 female; ages ranged from 45 to 70 years, with an average of 52.3 years; including Rutkow types (modified Gilbert types) I, II, III, V, and VI. All 10 patients successfully underwent MaDP TEP without vascular injury or conversion to open surgery. The postoperative day 1 pain NRS score was 1.50±0.53. During a follow-up of 1-19 weeks, there were no surgical site infections or hernia recurrences. At 3 weeks postoperatively, the SCAR scores for the 10 mm trocar site, the 5mm trocar site, and the MiniLap site were (5.10±1.25), (3.75±0.79), and (1.80±0.70) respectively, showing statistically significant differences (P<0.01). The unilateral hernia dissection operation time for the first 5 cases was (47.8±12.0) minutes and for the last 5 cases was (30.8±5.3) minutes, with a statistically significant difference (P=0.02).

MaDP TEP is safe and effective, offering minimal pain, excellent cosmetic results, and comparable performance to the traditional three-trocar TEP technique. With a short learning curve, it is suitable for widespread clinical adoption.