J Minim Invasive Surg 2016; 19(1): 25-31  https://doi.org/10.7602/jmis.2016.19.1.25
Single-Port Laparoscopic Total Extraperitoneal Inguinal Hernia Repair without Fixation of the Mesh
Sung Uk Bae, M.D.1, Byung Soh Min, M.D.2, Seung Hyuk Baik, M.D.2, Nam Kyu Kim, M.D.2, Hyuk Hur, M.D.2
Division of Colorectal Surgery, Department of Surgery, 1School of Medicine, Keimyung University and Dongsan Medical Center, Daegu, 2Colorectal Cancer Clinic, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Correspondence to: Hyuk Hur
Division of Colorectal Surgery, Department of Surgery, ColorectalCancer Clinic, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 41931, Korea
Tel: +82-2-2228-2139 Fax: +82-2-313-8289
E-mail: hhyuk@yuhs.ac
Received: October 2, 2015; Revised: December 14, 2015; Accepted: December 29, 2015; Published online: March 15, 2016.
© Journal of Minimally Invasive Surgery. All rights reserved.

cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: Single-port laparoscopic surgery has been used increasingly in treatment of a variety of conditions, and one recently introduced technique is single-port laparoscopic total extraperitoneal (SPLTEP) hernia repair. The aim of this study was to evaluate the safety and technical feasibility of SPLTEP hernia repair without fixation of the mesh. Methods: From June 2010 to October 2012, 112 consecutive patients underwent SPLTEP hernia repair. Results: We performed 129 inguinal hernia repairs in 112 patients, 17 were bilateral and 95 unilateral. There were 107 indirect hernias (83.0%), 20 direct hernias, and 2 hernias had both of types. Successful SPLTEP hernia repair was performed in 110 patients, with two conversions to an open surgical approach. Median operative times for unilateral and bilateral hernias were 70 minutes (40~145 minutes) and 90 minutes (67~135 minutes), respectively, and the hospital stay was 1 day (1~5 days). Postoperative complications included 10 patients with wound seromas or hematomas, 2 with urinary retention, 4 with groin pain, and 1 with bleeding from the incision site. There were 3 early recurrences (2.4%) during a median follow-up period of 42 months (range, 6~55). Conclusion: SPLTEP inguinal hernia repair without fixation of the mesh is both safe and technically feasible, and provides acceptable operative outcomes. Conduct of a prospective randomized study with long-term follow-up is needed to confirm the benefit of this technique in patients with inguinal hernia.
Keywords: Hernia, Inguinal herniorrhaphy, Laparoscopy
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