Zhang Yizhong, Wu Weidong, Chen Junjie, Si Xianke, Li Jian, Wang Tingfeng
Department of Hernia and Hepatobiliary Surgery, the First Affiliated Hospital of Ningbo University, 247 Renmin Road, Ningbo, 31500, China.
Gastrointestinal Surgery Department of General Surgery Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 85 Wujin Road, Shanghai, 200080, China.
Updates Surg. 2025 Jan;77(1):237-244. doi: 10.1007/s13304-024-02058-0. Epub 2024 Dec 18.
To evaluate the feasibility, safety, and efficacy of the lateral single-incision laparoscopic totally extraperitoneal (L-SILTEP) approach in patients with inguinal hernia who had contraindications to the midline approach. This study included 58 patients who underwent L-SILTEP. Data on their baseline characteristics and perioperative details were collected. Quality of life and cosmetic satisfaction assessments were performed. Of the evaluated patients, 25.9% had a history of middle and lower abdominal surgery and 10.3% had skin diseases around the umbilicus. The mean surgical duration, blood loss volume, and incision length were 53.5 (± 22.3) min, 7.2 (± 9.7) mL, and 2.0 (± 0.13) cm, respectively. Additionally, 29.3% of patients experienced intraoperative peritoneal rupture, and one patient had epigastric vessel bleeding. The 6-, 24-, and 48-h postoperative pain scores were 3.0 (± 0.6), 1.6 (± 0.6), and 1.1 (± 0.4), respectively. Postoperative complications included seroma (n = 3), hematoma (n = 1), and scrotal edema (n = 1). The surgical incision in the L-SILTEP approach was more aesthetically pleasing than that in previous surgeries. Approximately 17.2%, 8.6%, and 10.3% of patients reported pain, mesh sensation, and movement limitation, respectively. Severe or disabling symptoms were not reported, and there were no cases of 30-day readmissions. Hernia recurrence or incisional hernia was not observed over a mean follow-up duration of 14.6 (± 6.1) months. L-SILTEP can be used for patients with contraindications to the midline approach. Furthermore, it is a safe and effective procedure.
评估外侧单切口腹腔镜完全腹膜外（L-SILTEP）入路在有中线入路禁忌证的腹股沟疝患者中的可行性、安全性和有效性。本研究纳入了58例行L-SILTEP手术的患者。收集了他们的基线特征和围手术期详细资料。进行了生活质量和美容满意度评估。在评估的患者中，25.9%有中下腹部手术史，10.3%有脐周皮肤病史。平均手术时间、失血量和切口长度分别为53.5（±22.3）分钟、7.2（±9.7）毫升和2.0（±0.13）厘米。此外，29.3%的患者术中发生腹膜破裂，1例患者出现腹壁血管出血。术后6小时、24小时和48小时的疼痛评分分别为3.0（±0.6）、1.6（±0.6）和1.1（±0.4）。术后并发症包括血清肿（n = 3）、血肿（n = 1）和阴囊水肿（n = 1）。L-SILTEP入路的手术切口比以往手术更美观。分别约有17.2%、8.6%和10.3%的患者报告有疼痛、补片感觉和活动受限。未报告严重或致残症状，也没有30天再入院病例。在平均14.6（±6.1）个月的随访期内未观察到疝复发或切口疝。L-SILTEP可用于有中线入路禁忌证的患者。此外，它是一种安全有效的手术方法。
