Abstract
Purpose: To analyse the application prospects of single-hole laparoscopic hernia repair under the posterior rectus abdominis sheath.
Methods: A single 2.5-cm-long curved incision was made along the lower umbilical border. A 4 cm gap under the posterior rectus abdominis sheath was created. The silica gel sealing sleeve of an Iconport single-port device was wedged under the posterior rectus abdominis sheath. If the peritoneum was completely ruptured at the start of the procedure, an abdominal exploration was first performed, after which the peritoneal margin below the umbilicus can be located from the intraperitoneal view, and the peritoneal margin can be further pulled intraperitoneally to return to the preperitoneal space. Conventional laparoscopic instruments were used to complete the operation according to the procedure for totally extraperitoneal single-incision laparoscopic surgery (SILS-TEP).
Results: We retrospectively analysed 136 patients who underwent laparoscopic hernia repair, and SILS-TEP was successfully completed in 121 patients. The mean operative times were 83.8 minutes (range: 40-150 minutes) and 65.2 minutes (range: 36-110 minutes) for unilateral indirect hernia and unilateral direct hernia or femoral hernia, respectively. The mean postoperative hospital stay duration was 3.3 days.
Conclusions: Single-hole laparoscopic hernia repair has potential indications to surpass the efficiency of three-hole TAPP and three-hole TEP surgery.
Trial registration: the study was retrospectively registered with the Chinese Clinical Trial Registry (ChiCTR) (www.chictr.org.cn; registration number: ChiCTR1900023056; registration date: May 9, 2019).
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