Safety and efficacy of laparoendoscopic single-site surgery for abdominal wall hernias.

Tran, Hanh

BACKGROUND Laparoendoscopic single-site surgery has rapidly progressed from the animal laboratory to clinical use since mass production of multichannel ports began in 2007. Indeed, it has now been shown to be feasible and safe for many commonly performed operations. METHODS This study cohort comprised 22 unselected patients with abdominal wall hernias of varying types: multiply recurrent inguinal (n = 2), suprapubic (n = 1), ventral/incisional (n = 17), and parastomal hernias (n = 2), who underwent laparoendoscopic single-site ventral hernia repair between December 2009 and February 2011. Standard dissecting instruments and a 52 cm/5.5 mm/ 30 degree angle laparoscope were used. RESULTS Patients included 14 men and 8 women, with a median age of 56 (range, 32 to 78) years and a mean body mass index of 31.5 +/- 4.7 kg/m2. The mean mesh size was 460 cm2 (range, 225 to 884 cm2). Mean operation time was 125 minutes for ventral/incisional hernias and 270 minutes for parastomal hernias. No conversions to multiport or open surgeries were necessary. There was no mortality or morbidity, and no recurrence at 6- to 18-month follow-up. The mean satisfaction score was 2.7 (range, 2 to 3) with no patients reporting dissatisfaction with the procedure. CONCLUSION This series, though relatively small, represents a diverse group of patients with varying abdominal wall hernias, including parastomal hernias. These successful laparoendoscopic single-site surgeries, with no complications, demonstrate safety and efficacy, albeit in a specialized hernia center. This study is a prelude to the eventual validation of laparoendoscopic single-site hernia surgery with prospective randomized controlled trials.