Clinical Study Of Single Port Endoscopic Total Extra-peritoneal Inguinal Hernia Repair

Objective:This study evaluated the safety and effectiveness of single port endoscopic total extra-peritoneal repair in the treatment of inguinal hernia,and compared with the traditional operation method to determine its safety,minimally invasive and effective operation method.Methods:From January 2018 to December 2019,80 patients who underwent inguinal hernia repair in Affiliated Hospital of Inner Mongolia University of nationalities were randomly selected for prospective study with their informed consent.Among them,40 patients underwent single port laparoscopic operation and 40 patients underwent traditional inguinal hernia repair.All the patients were primary inguinal hernia,excluding incarcerated inguinal hernia,strangulated inguinal hernia and other complications.Blood loss,operative time,length of hospital stay,recovery days,intraoperative injuries,postoperative complications*such as infection rate,hematoma formation rate,urinary retention,24 hours pain,and recurrence rate were analyzed.Results:The average intraoperative bleeding volume of single port laparoscopic surgery was 5.68 ± 1.047,and the hospital stay was 3.73±2.17d,which was significantly lower than that of the traditional group 17.93 ± 1.774 ml and 4.95 ±1.30d(P<0.05).The average operation time of single port laparoscopic surgery(SPLS)and traditional laparoscopic surgery was 54.38±7.403 minutes and 49.28 ± 6.114 minutes,respectively(P<0.05).The mean recovery time of single port laparoscopic surgery(SPLS)and conventional surgery was 11.08 ± 2.795 days and 15.98 ± 1.121 days,respectively(P<0.05).The incidence of nerve injury was 1(2.5%)and 8(20%)in single port laparoscopy and traditional methods,respectively(P<0.014).Seroma formation and urinary retention after single port laparoscopic surgery were zero case(0%)and 2 cases(5%)respectively,while the conventional group was 5 cases(12.5%)and 9 cases(22.5%)respectively*the difference was statistically significant.The severity of 24-hour postoperative pain was assessed by visual analogue scale between the two groups.In the laparoscopic group,there were 15 cases(37.5%)with mild pain,18 cases(45%)with moderate pain and 7 cases(17.5%)with severe pain,while in the traditional operation group,there were 5 cases(12.5%)with mild pain,24 cases(60%)with moderate pain and 11 cases(27.5%)with severe pain(P<0.05).The rate of infection in inguinal hernia repair were 2 cases(5%)in single port laparoscopic surgery and 9 cases(22.5%)in traditional operation(p<0.05).The recurrence rate was 1 case(2.5%)in the single port laparoscopic group and 3 cases(7.5%)in the traditional group.Conclusion:Single port laparoscopic total extra-peritoneal inguinal hernia repair(SPLS-TEP)is more safe,effective,less bleeding,shorter hospital stay,early activity,less postoperative complications,and good cosmetic effect.