Wang Xiao-Jun, Fei Ting, Xiang Xiong-Hua, Wang Quan, Zhou En-Cheng
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Ningbo University, Ningbo 315020, Zhejiang Province, China.
Ambulatory Surgery Center, Xijing Hospital, Air Force Military Medical University, Xi'an 710032, Shaanxi Province, China.
World J Gastrointest Surg. 2024 Jul 27;16(7):2202-2210. doi: 10.4240/wjgs.v16.i7.2202.
The totally preperitoneal (TPP) approach is a new concept that was recently introduced. Although the TPP approach combined with single-incision laparoscopic hernia repair has its own advantages, there is little evidence reflecting the characteristics and feasibility of either approach.
To analyze the potential applications of single-incision laparoscopic TPP (SIL-TPP) inguinal hernia hernioplasty for the treatment of inguinal hernias.
A total of 152 SIL-TPP surgeries were performed at the First Affiliated Hospital of Ningbo University from February 2019 to November 2022. A single-port, named Iconport, and standard laparoscopic instruments were used during the operation. Demographic data, intraoperative parameters and short-term postoperative outcomes were collected and retrospectively analyzed.
The demographic data of 152 patients underwent SIL-TPP were shown in Table 1. The average age was 49.5 years (range from 21 to 81 years). The average body mass index was 27.7 kg/m (range from 17.7 kg/m to 35.6 kg/m). SIL-TPP were conducted successfully in 147 patients. Three patients were converted to the SIL-transabdominal preperitoneal laparoscopic herniorrhaphy at the initial stage of the study due to a lack of experience. In 2 patients with incisional hernias, an auxiliary operation hole was added during the SIL-TPP procedure, as required for surgery. The mean operative time was 64.5 minutes (range: 36.0-110.0 minutes) for unilateral direct and femoral hernias and 81.6 minutes for indirect hernias (range: 40.0-150.0 minutes). The mean postoperative hospital stay was 3.4 days.
SIL-TPP is feasible and has advantages for inguinal hernia repair. SIL-TPP has potential benefits for patients with various abdominal wall hernias. Consequently, doctors should be encouraged to actively apply the TPP approach combined with a single incision in their daily work.
完全腹膜前（TPP）入路是最近引入的一个新概念。尽管TPP入路结合单孔腹腔镜疝修补术有其自身优势，但几乎没有证据反映这两种入路的特点和可行性。
分析单孔腹腔镜TPP（SIL-TPP）腹股沟疝修补术在腹股沟疝治疗中的潜在应用。
2019年2月至2022年11月期间，宁波大学附属第一医院共进行了152例SIL-TPP手术。手术中使用了名为Iconport的单孔和标准腹腔镜器械。收集人口统计学数据、术中参数和术后短期结果并进行回顾性分析。
152例行SIL-TPP手术患者的人口统计学数据见表1。平均年龄为49.5岁（范围21至81岁）。平均体重指数为27.7kg/m（范围17.7kg/m至35.6kg/m）。147例患者SIL-TPP手术成功。3例患者在研究初期因经验不足转为SIL经腹腹膜前腹腔镜疝修补术。2例切口疝患者，根据手术需要在SIL-TPP手术过程中增加了一个辅助手术孔。单侧直疝和股疝的平均手术时间为64.5分钟（范围：36.0至110.0分钟），斜疝为81.6分钟（范围：40.0至150.0分钟）。术后平均住院时间为3.4天。
SIL-TPP用于腹股沟疝修补可行且具有优势。SIL-TPP对各种腹壁疝患者有潜在益处。因此，应鼓励医生在日常工作中积极应用TPP入路结合单切口。
