Abstract
Purpose: To evaluate the feasibility of SILS-TEP surgery via umbilical margin incision 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. The peritoneum was pressed down by the laparoscopic instrument to maintain tension, and the preperitoneal space was broadened towards the lower abdomen. Conventional laparoscopic instruments were used to complete the operation according to the procedure for laparoscopic totally extraperitoneal herniorrhaphy.
Results: SILS-TEP hernia repair was successfully completed in 102 patients. The mean operative times were 70.5 minutes (range, 40 to 130 minutes) and 52.8 minutes (range, 36 to 90 minutes) for unilateral indirect hernia and unilateral direct femoral hernia, respectively. Four seroma cases were seen during the 1- to 32-month follow-up periods, and all were treated conservatively. No other major complications were observed. The mean postoperative hospital stay duration was 3.3 days.
Conclusions: With the assistance of a suitable single-port laparoscopic device, SILS-TEP operation via umbilical margin incision under the posterior rectus abdominis sheath is safe and feasible as well as easy to master and popularize.
Trial registration: The study was retrospectively registered with the Chinese Clinical Trial Registry (Chi CTR) (www.chictr.org.cn; registration number: ChiCTR1900023056; registration date: May 9, 2019).
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