J Minim Invasive Surg 2015; 18(1): 24-29
SUTI (Single Umbilical Tangential Incision) Laparoscopic TEP Inguinal Hernia Repair
Myung-Hoon Lim, M.D., Ji-Young Sul, M.D., Ph.D.
Department of Surgery, Chungnam National University School of Medicine, Daejeon, Korea
Received: September 23, 2014; Revised: October 19, 2014; Accepted: October 23, 2014; Published online: March 15, 2015.
© The Korean Society of Endo-Laparoscopic & Robotic Surgery.

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/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: Single port laparoscopic inguinal hernia repair has been performed to further reduce port related morbidities and to improve the cosmetic outcome. However, the cosmetic result of single port laparoscopic totally extraperitoneal inguinal hernia repair (TEP) has not been superior to that of transabdominal preperitoneal hernia repair (TAPP). The aim of this study is to introduce and assess the Single Umbilical Tangential Incision (SUTI) for Lap-TEP repair.Methods: Forty one hernia repairs of 34 patients were performed using SUTI-TEP method. SUTI was made all along the inferolateral skin of the umbilical pit and a vertical incision of less than one centimeter was made in the supra- or infraumbilical skin if needed; the total length of the incision was 2~2.5 cm. SILSTM port and conventional instruments were used for the procedure.Results: All procedures were completed without conversion to the conventional TEP procedure. Mean operation time was 73 minutes for unilateral primary hernia, 119 minutes for bilateral primary hernia, 88.5 minutes for unilateral recurrent hernia, and 120 minutes for bilateral recurrent hernia. There were two cases of wound seroma and four cases of urinary retention postoperatively. Other significant complications were not noted. There was no recurrence of hernia during the follow-up period of one to 24 months. At routine follow-up visit at three months postoperative, the scar was barely visible and overall level of patient satisfaction was very high.Conclusion: The SUTI-TEP inguinal hernia repair is safe and shows superior cosmetic results. Further studies are required in order to assess the long-term outcome.
Keywords: Single incision, Single port, Laparoscopic totally extraperitoneal repair, Inguinal hernia
  1. Chamberlain RS, Sakpal SV. A comprehensive review of singleincision laparoscopic surgery (SILS) and natural orifice transluminal endoscopic surgery (NOTES) techniques for cholecystectomy. J Gastrointest Surg 2009;13:1733-1740.
    Pubmed CrossRef
  2. Gong K, Zhang N, Lu Y, et al. Comparison of the open tensionfree mesh-plug, transabdominal preperitoneal (TAPP), and totally extraperitoneal (TEP) laparoscopic techniques for primary unilateral inguinal hernia repair: a prospective randomized controlled trial. Surg Endosc 2011;25:234-239.
    Pubmed CrossRef
  3. He K, Chen H, Ding R, Hua R, Yao Q. Single incision laparoscopic totally extraperitoneal inguinal hernia repair. Hernia 2011;15:451453.
    Pubmed CrossRef
  4. Fuentes MB, Goel R, Lee-Ong AC, et al. Single-port endolaparoscopic surgery (SPES) for totally extraperitoneal inguinal hernia: a critical appraisal of the chopstick repair. Hernia 2013;17:217-221.
    Pubmed CrossRef
  5. Dowden RV. Transumbilical breast augmentation is safe and effective. Semin Plast Surg 2008;22:51-59.
    Pubmed KoreaMed CrossRef
  6. Choi YH, Sul JY. Long-term Outcomes of Laparoscopic Totally Extraperitoneal Inguinal Herniorrhaphy. J Minim Invasive Surg 2012;15:149-155.
  7. Cavale N, Butler PE. The ideal female umbilicus? Plast Reconstr Surg 2008;121:356e-357e.
    Pubmed CrossRef
  8. Meenakshi S, Manjunath KY. The tendinous intersections of rectus abdominis muscle. J MGIMS 2008;13:34-39.
  9. Wijerathne S, Agarwal N, Ramzy A, Lomanto D. A prospective randomized controlled trial to compare single-port endo-laparoscopic surgery versus conventional TEP inguinal hernia repair. [published online ahead of print Jun 6, 2014]. Surg Endosc; DOI 10.1007/s00464-014-3578-7.
  10. Kim Z, Cho SW, Kim YJ, et al. Laparoscopic Totally Extraperitoneal Herniorrhaphy: Is it Feasible for Recurrent Inguinal Hernias? J Korean Soc Endosc Laparosc Surg 2009;12:44-49.

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