Yussra Y, Sutton P A, Kosai N R, Razman J, Mishra R K, Harunarashid H, Das S
Departments of Surgery, Universiti Kebangsaan Malaysia Medical Centre, 56000 Kuala Lumpur, Malaysia.
Clin Ter. 2013;164(5):425-8. doi: 10.7417/CT.2013.1608.
Inguinal hernia remains the most commonly encountered surgical problem. Various methods of repair have been described, and the most suitable one debated. Single port access (SPA) surgery is a rapidly evolving field, and has the advantage of affording 'scarless' surgery. Single incision laparoscopic surgery (SILS) for inguinal hernia repair is seen to be feasible in both total extraperitoneal (TEP) and transabdominal pre-peritoneal (TAPP) approaches. Data and peri-operative information on both of these however are limited. We aimed to review the clinical experience, feasibility and short term complications related to laparoscopic inguinal hernia repair via single port access. A literature search was performed using Google Scholar, Springerlink Library, Highwire Press, Surgical Endoscopy Journal, World Journal of Surgery and Medscape. The following search terms were used: laparoscopic hernia repair, TAPP, TEP, single incision laparoscopic surgery (SILS). Fourteen articles in English language related to SILS inguinal hernia repair were identified. Nine articles were related to TEP repair and the remaining 5 to TAPP. A total of 340 patients were reported within these studies: 294 patients having a TEP repair and 46 a TAPP. Only two cases of recurrence were reported. Various ports have been utilized, including the SILS port, Tri-Port and a custom- made port using conventional laparoscopic instruments. The duration of surgery was 40-100 minutes and the average length of hospital stay was one day. Early outcomes of this novel technique show it to be feasible, safe and with potentially better cosmetic outcome.
腹股沟疝仍然是最常见的外科问题。已经描述了各种修复方法,并且对最合适的方法存在争议。单孔入路(SPA)手术是一个快速发展的领域,具有实现“无瘢痕”手术的优势。单切口腹腔镜手术(SILS)用于腹股沟疝修补在完全腹膜外(TEP)和经腹腹膜前(TAPP)两种入路中均被认为是可行的。然而,关于这两种方法的数据和围手术期信息都很有限。我们旨在回顾与单孔入路腹腔镜腹股沟疝修补相关的临床经验、可行性和短期并发症。使用谷歌学术、施普林格链接图书馆、Highwire出版社、《外科内镜杂志》、《世界外科杂志》和Medscape进行文献检索。使用了以下检索词:腹腔镜疝修补、TAPP、TEP、单切口腹腔镜手术(SILS)。确定了14篇与SILS腹股沟疝修补相关的英文文章。9篇文章与TEP修补相关,其余5篇与TAPP相关。这些研究共报道了340例患者:294例行TEP修补,46例行TAPP修补。仅报告了2例复发病例。使用了各种端口,包括SILS端口、三端口以及使用传统腹腔镜器械定制的端口。手术时间为40 - 100分钟,平均住院时间为1天。这项新技术的早期结果表明它是可行、安全的,并且可能具有更好的美容效果。