Single incision multiport versus conventional laparoscopic inguinal hernia repair: A matched comparison

• Published in: Journal of minimal access surgery 2018-01, Vol.14 (1), p.44-51
• Main Authors: Rajapandian, Subbiah, Bhushan, Chittawadagi, Sabnis, Sandeep C, Jain, Manish, Raj, Palanivelu Praveen, Parathasarthi, Ramakrishnan, Senthilnathan, Palanisamy, Palanivelu, Chinnusamy
• Format: Article
• Language: English
• Subjects: Analysis; Anesthesia; Care and treatment; Comparative analysis; Gastroenterology; Hernias; Hospitals; Inguinal hernia; Inguinal herniorrhaphy; laparoscopic hernia repair; Laparoscopy; Multivariate analysis; Original; Pain; Patient outcomes; Patients; Research centers; single-incision multiport laparoscopic surgery; Surgery; totally extra-peritoneal; Treatment outcome
• ISSN: 0972-9941; 1998-3921
• DOI: 10.4103/jmas.JMAS_30_17

The popularity of single-incision procedures is on the rise as wound cosmesis is increasingly being seen as an important body image-related outcome. In this study, we assess the potential benefits of single-incision multiport laparoscopic totally extra-peritoneal (S-TEP) without using specialised ports or instruments and compare the same with the conventional laparoscopic TEP (C-TEP) surgery in terms of operative time, post-operative pain, complications, cost and cosmesis. This is a prospective case-matched study of the patients undergoing S-TEP versus C-TEP from June 2014 to December 2015. Each group had 36 patients. The two groups were comparable in the clinical characteristics. The mean duration of surgery for a unilateral hernia in C-TEP and S-TEP was 45.13 ± 10.58 min and 72.63 ± 15.23 min, respectively. The mean visual analogue scale (VAS) score for pain was significantly higher in S-TEP group at post-operative day (POD) 0 and 1. However, at POD 7, there was no significant difference between the groups. At 1st and 6-week post-surgery, the cosmetic results were significantly better in S-TEP group as compared to C-TEP, however, at 6 months, the scar was highly acceptable in both treatment groups. S-TEP, using conventional laparoscopic instruments, is safe and feasible even in resource challenged setting. However, there is a need to review the indications and advantages of single-incision laparoscopic surgery, as no difference in cosmetic outcome by VAS score in S-TEP versus conventional laparoscopic arm seen by the end of 1 month.