Preliminary experience in using the lateral single-incision laparoscopic totally extraperitoneal approach for inguinal hernia repair.

Abstract

To evaluate the feasibility, safety, and efficacy of the lateral single-incision laparoscopic totally extraperitoneal (L-SILTEP) approach in patients with inguinal hernia who had contraindications to the midline approach. This study included 58 patients who underwent L-SILTEP. Data on their baseline characteristics and perioperative details were collected. Quality of life and cosmetic satisfaction assessments were performed. Of the evaluated patients, 25.9% had a history of middle and lower abdominal surgery and 10.3% had skin diseases around the umbilicus. The mean surgical duration, blood loss volume, and incision length were 53.5 (± 22.3) min, 7.2 (± 9.7) mL, and 2.0 (± 0.13) cm, respectively. Additionally, 29.3% of patients experienced intraoperative peritoneal rupture, and one patient had epigastric vessel bleeding. The 6-, 24-, and 48-h postoperative pain scores were 3.0 (± 0.6), 1.6 (± 0.6), and 1.1 (± 0.4), respectively. Postoperative complications included seroma (n = 3), hematoma (n = 1), and scrotal edema (n = 1). The surgical incision in the L-SILTEP approach was more aesthetically pleasing than that in previous surgeries. Approximately 17.2%, 8.6%, and 10.3% of patients reported pain, mesh sensation, and movement limitation, respectively. Severe or disabling symptoms were not reported, and there were no cases of 30-day readmissions. Hernia recurrence or incisional hernia was not observed over a mean follow-up duration of 14.6 (± 6.1) months. L-SILTEP can be used for patients with contraindications to the midline approach. Furthermore, it is a safe and effective procedure.