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