Retrospective comparison of open- versus single-incision laparoscopic extraperitoneal repair of inguinal hernia procedures: A single-institution experience

Purpose: In recent years, single-incision laparoscopic surgery (SILS) became more popular worldwide for its safety and feasibility. This study aims to compare the clinical outcomes of open- and single-incision laparoscopic total extraperitoneal (TEP) hernia repair procedures. Materials and Methods: This retrospective study included 498 consecutive patients undergoing open- and single-incision laparoscopic surgeries for inguinal hernia between January 2012 and December 2016 at Kaohsiung Municipal Ta-Tung Hospital. Results: Open inguinal hernia repairs were performed in 436 patients and SILS-TEP repairs in 62 patients. There were no significant differences between the two groups in patients' characteristics except hernia laterality. Mean operative time was significantly longer in the SILS-TEP compared with the open group (108.9 vs. 87.6 min, P = 0.001), but less mean operative duration was observed when surgeons performed bilateral SILS-TEP repairs. Minor amount of analgesic agent usage was noted in the SILS-TEP group. There were no significant differences between the two groups in bleeding volume and postoperative hospital stay and complications. There were 6/453 (1.3%) recurrences in the open group and no recurrences in the SILS-TEP group at a 1-year follow-up. Conclusion: SILS-TEP is both possibly safe and technically feasible and provides less postoperative pain, acceptable operative implications, and better cosmetic outcomes for patients. It also has less possibility of conversion to laparotomy and recurrence rate.