Page 86 - World Journal of Laparoscopic Surgery

A Prospective Observational Study on Single-incision or Conventional Three-port Laparoscopic TEP Inguinal Hernia Repair
Rate of Conversion to Open Technique group). However, 31 and 28% of cases of the CTEP group and SILS
In our study of 30 patients of inguinal hernia undergoing CTEP/SILS TEP group, respectively, had left-sided inguinal hernia.
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TEP, there was no conversion to open technique. Kim et al. in a study group of 60 patients with inguinal
hernias observed that 51.66% of patients had right-sided hernias,
Cost 43.33% of patients had left-sided hernias, and 5% patients had
In our study, the cost in SILS TEP group, using routine laparoscopic bilateral hernias.
instruments was not statistically different from the CTEP group Our results were consistent with the literature to find right-
without compromising patient safety. However, the actual cost sided inguinal hernia more common than left, then followed by
for SILS TEP when using specialized articulating instruments is bilateral hernia.
significantly higher.
Type of Hernia
In our study of 30 patients, most cases had an indirect inguinal
dIscussIon hernia. The indirect hernia was more common than the direct
Inguinal hernia repair is one of the most common elective hernia, with a ratio of 08/15 (53%) in the CTEP group and 09/15
procedures performed in general surgery. The goal of hernia repair (60%) in the SILS TEP group.
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includes achieving effective repair, lowest possible recurrence, Kim et al. in their study reported that indirect hernia was
minimizing intraoperative and postoperative complications, rapid present in 40/63 (63%) of cases undergoing SILS TEP. The direct
return to daily work, and reasons; various methods of inguinal hernia was present in 23/63 (37%) of cases undergoing SILS TEP.
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hernia repair have been utilized over the past. The technique of Tai et al. observed in their study that an indirect hernia was
herniorrhaphy has progressed from open to various laparoscopic more common than a direct hernia, with a ratio of 69/152 (45.4%) in
techniques. the CTEP group and 58/98 (59%) in the SILS TEP group. The direct
The present study was done to compare and analyze the results hernia was present in 68/152 (44.7%) of cases undergoing CTEP and
of laparoscopic CTEP and SILS TEP mesh repair for inguinal hernia. A 39/98 (39%) of cases undergoing SILS TEP.
total of thirty patients were included in the study. Fifteen patients Thus, on analyzing the above study and present study, it is
were operated on by laparoscopic CTEP hernioplasty and other evident that our results are consistent with the above studies.
fifteen were operated on by laparoscopic SILS TEP hernioplasty.
Operating Time
Age In our study, we observed that the mean operating time in the
The most common age-group in both the methods was 51–60 years CTEP group was 41.2 and 64.6 minutes for unilateral and bilateral
showing that groin hernia is most common in the middle age-group. inguinal hernias, respectively. The mean operating time for SILS
In CTEP group, the mean age was 50.67 years. In SILS TEP group, TEP was found to be 42.8 and 69.1 minutes for unilateral and
the mean age was 41.40 years. bilateral inguinal hernias, respectively. It was, however, observed
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Wijerathne et al. in their study reported that the mean age of that there was no statistically significant difference in operating
the patients undergoing CTEP was 50.3 and 47.2 years in patients time (p-value = 0.85).
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undergoing SILS TEP. Tai et al. in their study concluded that the mean operative
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Choi et al. observed in their study that the mean age in CTEP time in the CTEP group was 58.6 and 62.5 minutes for unilateral and
group was 57.5 years and for the SILS TEP group, it was 59.5 years. bilateral inguinal hernias, respectively; while the mean operative
time for SILS TEP was 82.3 and 68.3 minutes, respectively.
Sex Distribution Wijerathne et al. concluded in their study that the mean
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All the patients in our study were males. CTEP group consisted of operative time for unilateral inguinal hernias in CTEP and SILS TEP
15 patients, while the SILS TEP group also consisted of 15 patients. techniques was 50.5 and 63.5 minutes, respectively.
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Choi et al. reported that there were no female patients in either Choi et al., in their study concluded that the mean operative
of their study groups. time for CTEP was 41.6 minutes for unilateral hernias; while for SILS
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Kim et al. reported in their study that most of the patients were TEP, the mean operative time was 61.7 minutes.
males only accounting for 97% of cases. Two patients were female;
statistically, there was no difference between the two groups as Postoperative Complications
far as sex ratio is concerned. With these observations made, it is Overall complications were slightly more in the CTEP method than
concluded inguinal hernias occur commonly in males. in SILS TEP method five (33.3%) vs three (20%). The most common
complication was postoperative seroma in both groups. Three
Site of Hernia (20%) patients in the CTEP group and two (13%) patients in the SILS
In our study of 30 patients, most cases had a right-sided inguinal TEP group developed postoperative seroma which was noticed at
hernia. The CTEP group consisted of 15 patients. The right inguinal discharge and also at 1-week follow-up, which was conservatively
hernia was present in 10 (67%) cases. Left inguinal hernia was managed. One (7%) patient in the CTEP group developed hematoma
present in four (27%) cases. The bilateral inguinal hernia was present (managed conservatively). One (7%) patient in both groups had
in one (7%) case. The SILS TEP group consisted of 15 patients. The postoperative urinary retention, managed by catheterization.
right inguinal hernia was present in eight (53%) cases. Left inguinal Observations made in our study were consistent with studies by
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hernia was present in five (33%) cases. The bilateral inguinal hernia Choi et al., in their study have reported overall 24% of complications
was present in two (13%) cases. in the CTEP group and 16% in the SILS TEP group. Postoperative
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Choi et al. observed in their study that most cases had a seroma developed in 20% of cases in both groups. Urinary retention
right-sided inguinal hernia (69%—CTEP group and 73%—SILS TEP developed in 6 and 2% cases in CTEP and SILS TEP, respectively.

84 World Journal of Laparoscopic Surgery, Volume 15 Issue 1 (January–April 2022)