Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jan 27, 2024; 16(1): 49-58
Published online Jan 27, 2024. doi: 10.4240/wjgs.v16.i1.49
Single-incision laparoscopic transabdominal preperitoneal repair in the treatment of adult female patients with inguinal hernia
Xiao-Jun Zhu, Jing-Yi Jiao, Hui-Min Xue, Peng Chen, Chang-Fu Qin, Peng Wang
Xiao-Jun Zhu, Jing-Yi Jiao, Hui-Min Xue, Peng Chen, Peng Wang, Department of General Surgery, The Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
Jing-Yi Jiao, Peng Chen, Medical School, Nantong University, Nantong 226001, Jiangsu Province, China
Chang-Fu Qin, Department of Hernia and Abdominal Wall Surgery, Peking University People's Hospital, Beijing 100044, China
Co-first authors: Xiao-Jun Zhu and Jing-Yi Jiao.
Co-corresponding authors: Chang-Fu Qin and Peng Wang.
Author contributions: Zhu XJ, Jiao JY, Xue HM, Qin CF and Wang P conceived, designed and refined the study protocol; Zhu XJ, Jiao JY and Chen P were involved in the data collection; Zhu XJ, Jiao JY, Qin CF and Wang P analyzed the data; Zhu XJ and Jiao JY drafted the manuscript; All authors were involved in the critical review of the results and have contributed to, read, and approved the final manuscript. Zhu XJ and Jiao JY contributed equally to this work as co-first authors. Qin CF and Wang P contributed equally to this work as co-corresponding authors. The reasons for designating Zhu XJ and Jiao JY as co-first authors / Qin CF and Wang P as co-corresponding authors are threefold. First, the research was performed as a collaborative effort, and the designation of co-first and co-corresponding authorship accurately reflects the distribution of responsibilities and burdens associated with the time and effort required to complete the study and the resultant paper. This also ensures effective communication and management of post-submission matters, ultimately enhancing the paper's quality and reliability. Second, the overall research team encompassed authors with a variety of expertise and skills from different fields, and the designation of co-first and co-corresponding authors best reflects this diversity. This also promotes the most comprehensive and in-depth examination of the research topic, ultimately enriching readers' understanding by offering various expert perspectives. Third, the choice of these researchers as co-first and co-corresponding authors acknowledges and respects this equal contribution, while recognizing the spirit of teamwork and collaboration of this study. In summary, we believe that designating Zhu XJ and Jiao JY as co-first authors/Qin CF and Wang P as co-corresponding authors of is fitting for our manuscript as it accurately reflects our team's collaborative spirit, equal contributions, and diversity.
Supported by Wu Jieping Medical Foundation, No. 320.6750.18396; Nantong “14th Five-Year” Science and Education to Strengthen Health Project, General Surgery Medical Key Discipline, No. 42; and Nantong Municipal Commission of Health and Family Planning, No. MS2022005.
Institutional review board statement: The study was reviewed and approved by the Affiliated Hospital of Nantong University Institutional Review Board (Approval No. 2023-K117-01).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Data sharing statement: The datasets generated during and/or analysed during the current study are available from the corresponding author upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Peng Wang, MD, PhD, Chief Physician, Professor, Department of General Surgery, The Affiliated Hospital of Nantong University, No.20 Xisi Road, Nantong 226001, Jiangsu Province, China. dankongwang@ntu.edu.cn
Received: August 23, 2023
Peer-review started: August 23, 2023
First decision: November 21, 2023
Revised: December 9, 2023
Accepted: January 4, 2024
Article in press: January 4, 2024
Published online: January 27, 2024
Abstract
BACKGROUND

Women have a 3% lifetime chance of developing an inguinal hernia, which is not as common in men. Due to its cosmetic benefits, single-incision laparoscopic transabdominal preperitoneal (SIL-TAPP) inguinal hernia repair is becoming increasingly popular in the management of inguinal hernia in women. However, there are no studies comparing the safety and applicability of SIL-TAPP repair with conventional laparoscopic transabdominal preperitoneal (CL-TAPP) inguinal hernia repair for the treatment of inguinal hernia in women.

AIM

To compare the outcomes of SIL-TAPP and CL-TAPP repair in adult female patients with inguinal hernia and to estimate the safety and applicability of SIL-TAPP repair in adult female inguinal hernia patients.

METHODS

We retrospectively compared the clinical information and follow-up data of female inguinal hernia patients who underwent SIL-TAPP inguinal hernia repair and those who underwent CL-TAPP inguinal hernia repair at the Affiliated Hospital of Nantong University from February 2018 to December 2020 and assessed the long-term and short-term outcomes of both cohorts.

RESULTS

This study included 123 patients, with 71 undergoing SIL-TAPP repair and 52 undergoing CL-TAPP repair. The two cohorts of patients and inguinal hernia characteristics were similar, with no statistically meaningful difference. The rate of intraoperative inferior epigastric vessel injury was lower in patients in the SIL-TAPP cohort (0, 0%) than in patients in the CL-TAPP cohort (4, 7.7%) and was significantly different (P < 0.05). In addition, the median [interquartile range (IQR)] total hospitalization costs were significantly lower in patients in the SIL-TAPP cohort [$3287 (3218-3325)] than in patients in the CL-TAPP cohort [$3511 (3491-3599)]. Postoperatively, the occurrence rate of trocar site hernia was lower in the SIL-TAPP cohort (0, 0%) than in the CL-TAPP cohort (4, 7.7%), and the median (IQR) cosmetic score was significantly higher in the SIL-TAPP cohort [10 (10-10)] than in the CL-TAPP cohort [9 (9-10)].

CONCLUSION

SIL-TAPP repair did not increase the incidence of intraoperative and postoperative complications in female inguinal hernia patients. Moreover, female inguinal hernia patients who underwent SIL-TAPP repair had a lower probability of trocar site hernia and inferior epigastric vessel injury than female inguinal hernia patients who underwent CL-TAPP repair. In addition, female inguinal hernia patients who underwent SIL-TAPP repair reported a more aesthetically pleasing postoperative abdominal incision. Therefore, SIL-TAPP repair is a better option for the treatment of inguinal hernias in women.

Keywords: Single-incision, Groin hernia, Female, Inguinal hernia, Laparoscopic transabdominal preperitoneal inguinal hernia repair

Core Tip: This study is the first to compare the outcomes of single-incision laparoscopic transabdominal preperitoneal (SIL-TAPP) and conventional laparoscopic transabdominal preperitoneal (CL-TAPP) repair in adult female patients with inguinal hernia. We found that women who underwent SIL-TAPP repair had a lower chance of postoperative trocar site hernia and inferior epigastric vessel injury than those who underwent CL-TAPP repair, which is different from previous reports. Moreover, the results demonstrate the safety and applicability of SIL-TAPP repair in the treatment of adult female patients.