Transumbilical, Single-Port, Totally Extraperitoneal, Laparoscopic Inguinal Hernia Repair Using a Homemade Port and a Conventional Instrument: An Initial Experience

Abstract

To assess the feasibility, safety, and short-term outcome of a transumbilical, single-port, totally extraperitoneal (TEP) laparoscopic inguinal hernia repair, using a homemade port and a conventional instrument. Thirty consecutive patients with inguinal hernias (including 20% with bilateral inguinal hernias) underwent a transumbilical, single-port, TEP laparoscopic hernia (LH) repair using a homemade port composed of a segment of corrugated anesthesia tube and a pair of surgical gloves. All operation procedures were done using conventional laparoscopic instruments with manually angled shafts in the same manner as standard multiple-port surgeries, but using the reverse hand technique. All the procedures were completed uneventfully and did not require additional ports. Operation times averaged 98.3 ± 26.7 minutes for the unilateral LH and 121.4 ± 13.5 minutes for the bilateral LH. There were no perioperative complications except for 2 patients (7%) who developed wound seromas, which resolved after conservative treatment. No hernia recurred during the 6-month follow-up. A transumbilical, single-port, TEP laparoscopic hernioplasty using a homemade port and a conventional instrument permitted nearly scarless surgery for the treatment of inguinal hernias. Further studies are necessary before this approach can be recommended as a standard procedure.