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Laparoendoscopic single-site versus conventional laparoscopic total extraperitoneal hernia repair: a prospective randomized clinical trial

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Abstract

Background

This study aimed to compare laparoendoscopic single-site (LESS) total extraperitoneal (TEP) repair with conventional laparoscopic TEP repair for the treatment of inguinal hernias. To date, no other studies have compared the LESS and conventional laparoscopic TEP approaches for the treatment of inguinal hernia in a prospective randomized study setting.

Methods

For this study, 100 patients undergoing inguinal hernia repair were prospectively randomized into either the LESS TEP group or the conventional laparoscopic TEP group. Pre-, intra-, and postoperative factors were recorded. The primary end point was postoperative pain. The patients were interviewed at outpatient clinics at 1 week, 3 months, and 6 months postoperatively.

Results

The demographic data were comparable between the two groups. The median operative time was longer in the LESS TEP group (63.5 min) than in the conventional TEP group (50.5 min) (p = 0.001). No conversion was performed in either group. The mean pain score 2 h postoperatively during rest was significantly higher in the conventional TEP group than in the LESS TEP group (3.9 vs. 2.6; p = 0.02). The postoperative results were comparable between the groups in terms of analgesic requirements, systemic stress responses, complications, and postoperative convalescence.

Conclusions

The LESS TEP technique is associated with a longer operative time but offers the minor benefit of a reduction in immediate postoperative pain.

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Disclosures

Yao-Chou Tsai, Chen-Hsun Ho, Huai-Ching Tai, Shiu-Dong Chung, and Shih-Chieh Chueh have no conflicts of interest or financial ties to disclose.

Author information

Authors and Affiliations

  1. Department of Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan

    Yao-Chou Tsai

  2. Department of Urology, Tzu Chi University, Hualien, Taiwan

    Yao-Chou Tsai

  3. Department of Urology, National Taiwan University Hospital, Taipei, Taiwan

    Chen-Hsun Ho & Huai-Ching Tai

  4. Department of Surgery, Far Eastern Memorial Hospital, Ban Ciao, Taipei

    Shiu-Dong Chung

  5. National Taiwan University Hospital, Taipei, Taiwan

    Shih-Chieh Chueh

  6. Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA

    Shih-Chieh Chueh

  7. Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA

    Shih-Chieh Chueh

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  1. Yao-Chou Tsai
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  2. Chen-Hsun Ho
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  5. Shih-Chieh Chueh
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Correspondence to Yao-Chou Tsai.

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Tsai, YC., Ho, CH., Tai, HC. et al. Laparoendoscopic single-site versus conventional laparoscopic total extraperitoneal hernia repair: a prospective randomized clinical trial. Surg Endosc 27, 4684–4692 (2013). https://doi.org/10.1007/s00464-013-3116-z

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  • DOI: https://doi.org/10.1007/s00464-013-3116-z

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