Over the past century, various hernia repair surgeries have been generated by surgeons. Totally extraperitoneal (TEP) and transperitoneal hernioplasty (TAPP) are commonly used for laparoscopic inguinal hernia repair. Single-incision laparoscopy totally extraperitoneal hernioplasty (SIL-TEP), first introduced by Filipovic-Cugura et al. in 2009, has gained popularity due to its advantages...
Over the past century, various hernia repair surgeries have been generated by surgeons. Totally extraperitoneal (TEP) and transperitoneal hernioplasty (TAPP) are commonly used for laparoscopic inguinal hernia repair. Single-incision laparoscopy totally extraperitoneal hernioplasty (SIL-TEP), first introduced by Filipovic-Cugura et al. in 2009, has gained popularity due to its advantages like cosmesis, pain-reducing, and rapid recovery benefits.
In their recent study published in BMC Surgery, Qing Huang and colleagues concluded that the single-incision laparoscopic totally preperitoneal (SIL-TPP) hernia repair is a superior procedure with distinguished advantages like large and simple space. Based on their study findings, they recommend it rather than SIL-TEP for the management of inguinal hernia, especially for indirect hernia.
This study was conducted to evaluate the feasibility of SIL-TPP and compare its outcomes with SIL-TEP. The study involved 256 patients who underwent surgery at the First Hospital of Ningbo University between August 2018 and July 2022.
Key findings from the study results are:
• All patients underwent successful SIL-TPP and SIL-TEP hernia repair without any conversations between the groups.
• Patients' demographics were comparable between the two groups, comparing the initial 52 cases analysis.
• The mean unilateral hernia operative time was significantly shorter in the SIL-TPP group than in the SIL-TEP group (unilateral: 81.38 ± 25.32 vs. 95.96 ± 28.54).
• Further study of unilateral hernia operative time revealed the mean indirect hernia operative time was significantly shorter in the SIL-TPP group than the SIL-TEP group (indirect: 81.38 ± 25.33 vs. 95.87 ± 28.54).
• The unilateral hernia operation time trend of the initial 52 cases of two group analysis revealed the operation time of SIL-TPP reduced faster than SIL-TEP along with treating number increasing
• comparison of initial equal quantity unilateral hernia patient mean operative time revealed the SIL-TPP group was significantly shorter than the SIL-TEP group (85.77 ± 22.76 vs. 95.87 ± 28.54).
• The rate of peritoneum tearing of the SIL-TPP group was significantly high than that of SIL-TEP
In conclusion, they said SIL-TPP is at least as effective as SIL-TEP. This procedure is safe and superior, and we recommend it rather than SIL-TEP for treating inguinal hernia.
Retrospective study, loss of follow-up, and small sample size were some of the study's limitations.
References:
Huang, Q., Wang, X., Xiang, X. et al. TPP (totally preperitoneal) making single incision laparoscopic inguinal hernia repair more feasible: a comparison with single incision laparoscopic totally extraperitoneal hernioplasty (SIL-TEP). BMC Surg 24, 81 (2024). https://doi.org/10.1186/s12893-024-02372-9
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