Kim J H, An C H, Lee Y S, Kim H Y, Lee J I
Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, #665, Bupyung-6-dong, Bupyunggu, Incheon, 403-720, Korea.
Hernia. 2015 Jun;19(3):417-22. doi: 10.1007/s10029-014-1337-2. Epub 2014 Dec 24.
Reports have been issued recently on single incision laparoscopic hernioplasty, but no large-scale study has been conducted as yet. This study aimed to assess the safety and feasibility of the single incision laparoscopic totally extraperitoneal hernioplasty (SIL-TEP) on a large number of cases.
512 SIL-TEPs in 471 patients were performed from June 2010 to January 2014 at Incheon St. Mary's Hospital, The Catholic University of Korea. SIL-TEP was performed using a glove single port device and standard laparoscopic instruments. Short-term outcomes were reviewed.
Of the 512 hernias, 329 (64.3 %) were indirect, 144 (28.1 %) were direct, 9 (1.8 %) were femoral, and 30 (5.9 %) were combined. There were 3 (0.6 %) conversions to single or three-port laparoscopic transabdominal preperitoneal hernioplasty. Mean operative time was 41.6 min for unilateral hernias and 65.3 min for bilateral hernias. Postoperative complications occurred in 45 cases (9.6 %); 21 were wound seromas, 5 were hematomas, and 18 were urinary retentions. All were successfully treated conservatively. Mean hospital stay was 1.8 days.
The SIL-TEP is safe and technically feasible. Additional studies on long-term recurrence rates are needed to confirm the safety of SIL-TEP.
近期已有关于单切口腹腔镜疝修补术的报道，但尚未进行大规模研究。本研究旨在评估大量病例中经单切口腹腔镜完全腹膜外疝修补术（SIL-TEP）的安全性和可行性。
2010年6月至2014年1月，在韩国天主教大学仁川圣母医院对471例患者实施了512例SIL-TEP手术。使用手套单孔装置和标准腹腔镜器械进行SIL-TEP手术。回顾短期结果。
在512例疝中，329例（64.3%）为间接疝，144例（28.1%）为直接疝，9例（1.8%）为股疝，30例（5.9%）为复合疝。有3例（0.6%）转为单孔或三孔腹腔镜经腹腹膜前疝修补术。单侧疝平均手术时间为41.6分钟，双侧疝为65.3分钟。术后并发症发生45例（9.6%）；21例为伤口血清肿，5例为血肿，18例为尿潴留。所有病例均经保守治疗成功治愈。平均住院时间为1.8天。
SIL-TEP是安全的且技术上可行。需要进一步研究长期复发率以确认SIL-TEP的安全性。
