單孔腹腔鏡及傳統腹腔鏡腹膜外腹股溝疝氣修補手術的比較
陳經國、黃冠華1
奇美醫學中心 外科部 泌尿外科，1泌尿腫瘤科
Comparison of Laparoendoscopic single-site (LESS) and conventional laparoscopic totally extra-peritoneal (TEP) inguinal hernia repair
Keng-Kok Tan, Kuan-Hua Huang1
Division of Urology, Department of Surgery, 1Division of Uro-Oncology
Chi Mei Medical Center
Introduction:
The success of laparoscopic surgery is due to the less surgical trauma, including less operative pain, complications and better cosmetics (less wound). However, conventional laparoscopic hernia repair usually requires three working port and each increasing port is associated with possible increasing morbidity and pain related to ports. This has led to the development of laparoendoscopic single-site hernia repair which can further reduce the port-related morbidities and improve cosmetic outcomes.
Patients and Methods:
We performed a retrospective analysis of 78 patients (LESS-TEP, 36; conventional laparoscopic-TEP, 42) scheduled to undergo elective inguinal hernia from January 2013 to December 2014 by single surgeon at Chi Mei Medical Center. Data regarding patient demographics, type of hernia, operative time, complications, postoperative hospital stay, and recurrence were analyzed and compared.
Results:
There were no significant differences in the patient demographics. All 36 patients in LESS-TEP group were bilateral hernia, 40 patients in conventional laparoscopic-TEP group were bil hernia and 2 were unilateral hernia. There were no significant differences in thr length of operation time (LESS-TEP, 93.88 min vs. conventional laparoscopic-TEP, 82.02 min). Mean hospital stay were 2.77 days in LESS-TEP group and 3.16 days in conventional laparoscopic-TEP group. Additional pain control seem more often in conventional laparoscopic-TEP group (32/42, 76.2% vs 20/36, 55.5%). No recurrence reported in both group during a mean follow-up period of 11.14 months in LESS-TEP group and 16.85 months in conventional laparoscopic-TEP group.
Conclusion:
In our experience, LESS-TEP hernia repair seems to be safe and feasible procedure. There were no significant differences in the postoperative hospital stay, operative time and complications rates compared with conventional laparoscopic TEP hernia repair.