Laparoendoscopic Single-Site Surgery (LESS) in Totally Extraperitoneal (TEP) Inguinal Hernia Repair: Initial Experience

Abstract

Background: Laparoscopic inguinal hernia repair was introduced in the early 1990s. A novel surgical approach known as laparoendoscopic single-site surgery (LESS) has been developed to reduce the port-related morbidities and improve the cosmetic outcomes of laparoscopic surgery, including totally extraperitoneal (TEP) inguinal hernia repair.The aim of the this study is to present our initial experience with LESS TEP.Materials and Methods: Between April, 2013 and January, 2016, 21 healthy patients (18 men and 3 women) underwent LESS TEP inguinal hernia repair performed by the same surgical team. The first 5 procedures were performed using Covidien SILS port for simultaneous passage of the laparoscope and the instruments. All of the other surgeries were performed using Karl Storz Curcillo trocars, passed trough a single incision. The perioperative data, including patient age, sex, body mass index (BMI), hernia characteristics, operative time, complications, length of hospital stay, return to normal activity, pain score, and cosmetic results, were prospectively collected.Results: Twenty LESS TEP procedures were completed successfully and one had to be converted to a standard 3 port laparoscopic surgery, because of a peritoneal breach.The mean operative time was significantly shorter in the standard TEP series (61.8±26.0 vs. 105.9±23.8 min.). There were no complications. The average hospital stay was 1.3 days.Conclusion: Our short-term experience with LESS TEP inguinal hernia repair has shown that in experienced hands, inguinal hernia repair via the LESS TEP technique is as safe as the standard TEP technique. But the question whether is it worth still remains.