Yang G P C, Lai E C H, Chan O C Y, Tang C N, Li M K W
Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong, China.
Asian J Endosc Surg. 2011 Nov;4(4):166-70. doi: 10.1111/j.1758-5910.2011.00098.x. Epub 2011 Aug 3.
Laparoscopic inguinal hernia repair is currently one of the most commonly performed minimally invasive surgical procedures. In recent years, single-incision operations have been developed to further reduce the invasiveness of the surgery. Herein, we report our early experience with single-incision laparoscopic inguinal hernia repair in Asia, with both the transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) approaches.
This is a retrospective review of prospectively collected data on a cohort of consecutive patients with inguinal hernia who underwent single-incision laparoscopic inguinal hernia repair in a minimal access surgical center in Hong Kong between January 2010 and January 2011.
Our cohort consists of 15 patients who underwent single-incision laparoscopic inguinal hernia; 13 were unilateral and two were bilateral hernias. The mean age was 59.8 years old (range, 28-74 years). The overall mean operative time was 59.53 min (range, 25-120 min). For unilateral hernia repair, the mean operative time was 56 min (range, 25-75 min) and 48.5 min (range, 41-55 min) for TAPP and TEP, respectively. In all cases single-incision laparoscopic hernia repair was successfully performed, no additional trocars were required, and there were no conversions to conventional laparoscopic or open inguinal hernia repair. All patients were discharged on the same day as the procedure.
Single-incision laparoscopic inguinal hernia is feasible in both TEP and TAPP approaches. The procedure should be performed by laparoscopic surgeons with a high level of experience in single-incision surgery. Further randomized trials should be performed to evaluate the full potential and clinical application of single-incision TAPP and TEP.
腹腔镜腹股沟疝修补术是目前最常施行的微创手术之一。近年来，单切口手术已得到发展，以进一步降低手术的侵袭性。在此，我们报告我们在亚洲开展单切口腹腔镜腹股沟疝修补术（经腹腹膜前修补术（TAPP）和完全腹膜外修补术（TEP）两种方法）的早期经验。
这是一项对前瞻性收集的数据进行的回顾性研究，研究对象为2010年1月至2011年1月期间在香港一个微创外科中心接受单切口腹腔镜腹股沟疝修补术的连续腹股沟疝患者队列。
我们的队列包括15例行单切口腹腔镜腹股沟疝修补术的患者；13例为单侧疝，2例为双侧疝。平均年龄为59.8岁（范围28 - 74岁）。总体平均手术时间为59.53分钟（范围25 - 120分钟）。对于单侧疝修补，TAPP和TEP的平均手术时间分别为56分钟（范围25 - 75分钟）和48.5分钟（范围41 - 55分钟）。所有病例均成功施行单切口腹腔镜疝修补术，无需额外的套管针，也未转为传统腹腔镜或开放腹股沟疝修补术。所有患者均在手术当天出院。
TEP和TAPP两种方法行单切口腹腔镜腹股沟疝修补术均可行。该手术应由在单切口手术方面经验丰富的腹腔镜外科医生施行。应进行进一步的随机试验，以评估单切口TAPP和TEP的全部潜力及临床应用。
