J Minim Invasive Surg 2018; 21(3): 118-123  
Left Side Approach in Laparoscopic Transabdominal Preperitoneal Inguinal Herniorrhaphy is Feasible for Any Type of Inguinal Hernia
Hyung jin Cho, M.D., Dong Jin Kim, M.D., Ph.D.
Department of Sugery, College of Medicine, The Catholic University of Korea, Seoul, Korea
Correspondence to: Dong Jin Kim
Department of Sugery, St. Paul’s Hospital, College of Medicine, The Catholic University of Korea, 180, Wangsan-ro, Dongdaemun-gu, Seoul 02559, Korea
Tel: +82-2-961-4511 Fax: +82-2-786-4911 E-mail: djdjcap@catholic.ac.kr
ORCID:http://orcid.org/0000-0001-5103-5607
Received: May 11, 2018; Revised: July 12, 2018; Accepted: August 1, 2018; Published online: September 15, 2018.
© 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: The transabdominal preperitoneal (TAPP) method has been as popular as the totally extraperitoneal (TEP) approach for laparoscopic inguinal hernia repair. The preferred approach to TAPP has been inserting two operative trocars in the contralateral midclavicular line, respectively. This can be uncomfortable for surgeons with a shorter reach. For this reason, we developed an only left side TAPP approach(L-TAPP) through an ipsilateral trocar position on the patient’s left side regardless location of inguinal hernia.
Methods: We included patients who underwent laparoscopic inguinal hernia repair by a single surgeon between April 2016 and August 2017. The patients were divided into TEP and L-TAPP groups and compared regarding the clinical characteristics and surgical outcomes.
Results: There were no differences in clinicopathologic characteristics between the 33 patients in L-TAPP group and 11 patients in TEP group. The mean operative time for the L-TAPP group was 71.4±20.5 min, and 75.8±17.4 min for the TEP group (p=0.522). The mean length of hospital stay for the L-TAPP group was 2.5±0.7 days, and 2.5±0.5 days (p=0.797) for the TEP group. There was one postoperative scrotal hematoma and cord edema in the TEP group and no complications in the L-TAPP group (p=0.219). There were no early recurrences in both groups.
Conclusion: In conclusion, L-TAPP is a feasible and safe procedure compared with TEP. In addition, this procedure might be adopted with more comfort for surgeons who have short reaches.
Keywords: Laparoscopy, Abdominal wall, Inguinal hernia


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