Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jul 27, 2024; 16(7): 2202-2210
Published online Jul 27, 2024. doi: 10.4240/wjgs.v16.i7.2202
Potential applications of single-incision laparoscopic totally preperitoneal hernioplasty
Xiao-Jun Wang, Ting Fei, Xiong-Hua Xiang, Quan Wang, En-Cheng Zhou
Xiao-Jun Wang, Ting Fei, Xiong-Hua Xiang, En-Cheng Zhou, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Ningbo University, Ningbo 315020, Zhejiang Province, China
Quan Wang, Ambulatory Surgery Center, Xijing Hospital, Air Force Military Medical University, Xi’an 710032, Shaanxi Province, China
Author contributions: Wang XJ and Zhou EC designed the research; Wang XJ, Fei T, and Wang Q performed the surgery and collected the data; Wang XJ, Xiang XH, and Zhou EC analyzed the data and wrote the manuscript; and all authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of The First Affiliated Hospital of Ningbo University (Approval No. 2019KY0401).
Informed consent statement: Written informed consent was obtained from the patients or their legal guardian.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
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: En-Cheng Zhou, MM, Attending Doctor, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Ningbo University, No. 247 Renmin Road, Ningbo 315020, Zhejiang Province, China. zhouencheng@126.com
Received: May 7, 2024
Revised: June 11, 2024
Accepted: June 24, 2024
Published online: July 27, 2024
Processing time: 75 Days and 23.8 Hours
Abstract
BACKGROUND

The totally preperitoneal (TPP) approach is a new concept that was recently introduced. Although the TPP approach combined with single-incision laparoscopic hernia repair has its own advantages, there is little evidence reflecting the characteristics and feasibility of either approach.

AIM

To analyze the potential applications of single-incision laparoscopic TPP (SIL-TPP) inguinal hernia hernioplasty for the treatment of inguinal hernias.

METHODS

A total of 152 SIL-TPP surgeries were performed at the First Affiliated Hospital of Ningbo University from February 2019 to November 2022. A single-port, named Iconport, and standard laparoscopic instruments were used during the operation. Demographic data, intraoperative parameters and short-term postoperative outcomes were collected and retrospectively analyzed.

RESULTS

The demographic data of 152 patients underwent SIL-TPP were shown in Table 1. The average age was 49.5 years (range from 21 to 81 years). The average body mass index was 27.7 kg/m2 (range from 17.7 kg/m2 to 35.6 kg/m2). SIL-TPP were conducted successfully in 147 patients. Three patients were converted to the SIL-transabdominal preperitoneal laparoscopic herniorrhaphy at the initial stage of the study due to a lack of experience. In 2 patients with incisional hernias, an auxiliary operation hole was added during the SIL-TPP procedure, as required for surgery. The mean operative time was 64.5 minutes (range: 36.0-110.0 minutes) for unilateral direct and femoral hernias and 81.6 minutes for indirect hernias (range: 40.0-150.0 minutes). The mean postoperative hospital stay was 3.4 days.

CONCLUSION

SIL-TPP is feasible and has advantages for inguinal hernia repair. SIL-TPP has potential benefits for patients with various abdominal wall hernias. Consequently, doctors should be encouraged to actively apply the TPP approach combined with a single incision in their daily work.

Keywords: Totally preperitoneal hernioplasty; Iconport; Single incision laparoscopic; Totally extraperitoneal herniorrhaphy; Single incision laparoscopic totally preperitoneal hernioplasty

Core Tip: Totally preperitoneal (TPP) is a novel concept that was recently introduced and differs from totally extraperitoneal hernioplasty (TEP). Our previous findings suggested that the TPP approach could advance single-incision laparoscopic (SIL) inguinal hernia repair of unilateral inguinal hernias more feasibly than could SIL-TEP. The procedure was named SIL-TPP. SIL-TPP has unique characteristics and advantages. However, evidence for the characteristics of the SIL-TPP or TPP approach is scarce. SIL-TPP has potential benefits for patients with various abdominal wall hernias. In addition, the TPP approach combined with a single incision merits further research to elucidate its feasibility and advantages for treating other abdominal hernias, including emergency cases, incisional hernias, and umbilical hernias.