Huang Qing, Wang Xiaojun, Hu Li, Xiang Xionghua, Qi Changlei, Fei Ting, Zhou Encheng
Emergency Department, The First Affiliated Hospital of Ningbo University, 59 Liuting Road, Ningbo, Zhejiang, 315000, China.
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Ningbo University, 59 Liuting Road, Ningbo, Zhejiang, 315000, China.
BMC Surg. 2024 Dec 5;24(1):386. doi: 10.1186/s12893-024-02626-6.
The aim of this study was to introduce and assess the safety and feasibility of single incision laparoscopic totally preperitoneal hernioplasty (SIL-TPP) for bilateral inguinal hernia repair.
Forty-two SIL-TPP procedures for bilateral inguinal hernia repair were conducted from June 2018 to July 2022 at the First Affiliated Hospital of Ningbo University using standard laparoscopic instruments and a single-port device. Clinical data such as demographic intraoperative parameters and short-term postoperative outcomes were collected and analysed.
SIL-TPP was successful in 42 bilateral inguinal hernia patients, and no conversion occurred. Of these 42 patients, 38 were males and 4 were females. The average age was 57.4 ± 17 years. The participants' mean BMI was 22.67 ± 2.19 kg/m2 (range from 18.65 to 28.71 kg/m2). There were 4 types of bilateral hernias. The percentage of patients who underwent surgery before the SIL-TPP procedure in the same region was 21.43% (9/42). The mean operative time was 114 ± 34.24 min (range, 70-215 min). A total of 11 intraoperative complications occurred in 42 bilateral inguinal hernia patients, including unintentional peritoneum tears and hernia sac tears. No major complications occurred in the study. The postoperative complication rate was 2.38% (1/42). One patient experienced intestinal obstruction after the operation that resolved spontaneously without treatment. The surgical time in the SIL-TPP group decreased gradually as the number of operations increased. Moreover, the operation time trend decreased linearly (P < 0.0001, R²=0.42).
SIL-TPP is a safe and feasible procedure for treating bilateral inguinal hernias. The SIL-TPP procedure requires distinct skills and has specific advantages in treating bilateral hernias. Large-scale randomized controlled studies comparing SIL-TPP with conventional single-port and three-port laparoscopic TEP for bilateral inguinal hernia are needed to confirm these results.
本研究旨在介绍并评估单切口腹腔镜完全腹膜前疝修补术（SIL-TPP）用于双侧腹股沟疝修补的安全性和可行性。
2018年6月至2022年7月期间，在宁波大学第一附属医院使用标准腹腔镜器械和单孔装置对42例双侧腹股沟疝患者进行了SIL-TPP手术。收集并分析了人口统计学、术中参数和术后短期结果等临床数据。
42例双侧腹股沟疝患者的SIL-TPP手术均成功，无中转情况。这42例患者中，男性38例，女性4例。平均年龄为57.4±17岁。参与者的平均体重指数为22.67±2.19kg/m²（范围为18.65至28.71kg/m²）。有4种类型的双侧疝。在同一区域接受过SIL-TPP手术前手术的患者比例为21.43%（9/42）。平均手术时间为114±34.24分钟（范围为70至215分钟）。42例双侧腹股沟疝患者术中共发生11例并发症，包括意外腹膜撕裂和疝囊撕裂。本研究未发生重大并发症。术后并发症发生率为2.38%（1/42）。1例患者术后出现肠梗阻，未经治疗自行缓解。随着手术例数的增加，SIL-TPP组的手术时间逐渐缩短。此外，手术时间呈线性下降趋势（P<0.0001，R²=0.42）。
SIL-TPP是一种治疗双侧腹股沟疝安全可行的手术方法。SIL-TPP手术需要独特的技巧，在治疗双侧疝方面具有特定优势。需要开展大规模随机对照研究，比较SIL-TPP与传统单孔和三孔腹腔镜TEP治疗双侧腹股沟疝的效果，以证实这些结果。
