title: Single-port endo-laparoscopic surgery (SPES) for totally extraperitoneal inguinal hernia: a critical appraisal of the chopstick repair.
abstract: OBJECTIVE
  Developments in minimal access surgery brought a new concept: single-port endolaparoscopic surgery (SPES). The aim of our study is to verify the safety and feasibility of SPES TEP hernia repair and report our initial clinical outcome.
  
  
  METHODS
  We prospectively collected data of all patients who underwent SPES TEP repair from May 2009 to December 2010. Data regarding patient demographics, type, size and location of hernia, port devices used, type of mesh and fixation, operative time, complications, length of stay and cosmetic results were collected and analyzed.
  
  
  RESULTS
  A total of 47 patients (36 M, 11 F) underwent 70 SPES TEP hernia repairs; median age was 53 years (range 22-80). 60 % had indirect hernia, 27.5 % direct, 8.5 % pantaloon, 2 % femoral and 2 % recurrent hernias. Mean hernia size was 1.91 ± 0.67 cm. Port devices used include 33 Triport, 12 SILS and 2 SSL. We used anatomical mesh in 20; flat polypropylene in 10 and titanium-coated polypropylene mesh in 17 patients. Fixation of mesh was achieved in 18 patients with absorbable tacks, 8 with titanium tacks, 1 with fibrin glue, and no tack in 20 with anatomical mesh. No conversions occurred and small seroma was reported in 3 (6.3 %) patients. Mean operative time was 96.48 min (range: 50-150). Average hospital stay was 11.8 h (range: 9-26). Median follow-up was 11 months (range 6-18), and no recurrence was noted. 82.6 % patients were very satisfied, and 17.4 % were satisfied with the procedure.
  
  
  CONCLUSIONS
  SPES TEP repair is a safe and feasible technique with good patient satisfaction.
authors: Department of Surgery, Yong Loo Lin School of Medicine, Minimally Invasive Surgical Centre, National University of Singapore, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore.
authors: M B
authors: MB
authors: Fuentes
authors: R
authors: R
authors: Goel
authors: A C
authors: AC
authors: Lee-Ong
authors: E B
authors: EB
authors: Cabrera
authors: M
authors: M
authors: Lawenko
authors: J
authors: J
authors: Lopez-Gutierrez
authors: D
authors: D
authors: Lomanto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D059032:Learning Curve; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D013526:Surgical Mesh