J Korean Surg Soc.  2011 May;80(5):319-326. 10.4174/jkss.2011.80.5.319.

Laparoscopic totally extraperitoneal repair without suprapubic port: comparison with conventional totally extraperitoneal repair

• Kwon KH
• Son BH
• Han WK

• KMID: 2212156
• DOI: http://doi.org/10.4174/jkss.2011.80.5.319

Abstract

PURPOSE
We have treated 24 patients through laparoscopic totally extraperitoneal (TEP) repair without suprapubic port by using reliability and reducing the invasiveness of two surgery. This study is aimed to assess the safety and feasibility of the TEP repair without suprapubic port compared to conventional TEP repair.
METHODS
From September 2007 to 11 May 2010, we compared two groups that suffer from inguinal hernias. One is comprised of 24 patients who were treated without suprapubic port laparoscopic totally extraperitoneal repair (Group A), and the other is comprised of 100 patients who were treated with conventional laparoscopic totally extraperitoneal repair (Group B). Data regarding patient demographics (sex, age, site of hernia, and the type of hernia), operating time, postoperative hospital stay, the use of analgesics, and complications were prospectively collected.
RESULTS
There was no significant difference noted between two groups in relation to sex, age, site, and the type of hernia. The mean operating time and postoperative hospital stay was longer for the Group B (62.9 minutes, 3.55 days) than for the Group A (59.0 minutes, 2.54 days) (P = 0.389, P < 0.001). Postoperative urinary retention, seroma, wound infection were respectively 4.2%, 8.3%, 0% in Group A, and 12.0%, 8.0%, 7% in group B. There was difference between the two groups, but not statistical significance. Group B used more analgesics than Group A (0.33 vs. 0.48), but it wasn't significant statistically (P = 0.234).
CONCLUSION
Although prospective randomized studies with long-term follow-up evaluation are needed to confirm our study between laparoscopic totally extraperitoneal repair without suprapubic-port and conventional laparoscopic totally extraperitoneal repair, our method have some advantages in postoperative pain, urinary retention, operating time, postoperative hospital stay, and cosmetic effect.

Keyword

Inguinal hernia; Laparoscopic surgery; Totally extraperitoneal repair

MeSH Terms

Analgesics
Cosmetics
Demography
Follow-Up Studies
Hernia
Hernia, Inguinal
Humans
Laparoscopy
Length of Stay
Pain, Postoperative
Prospective Studies
Pyrazines
Seroma
Urinary Retention
Wound Infection
Analgesics
Cosmetics
Pyrazines

Figure

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  Fig. 1 Image of port insertion state.

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  Fig. 2 Intraoperative appearance in totally extraperitoneal approach with (A) vs. without (B) suprapubic port.

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  Fig. 3 Postoperative appearance in totally extraperitoneal approach without suprapubic port.

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