Laparoendoscopic single-site herniorrhaphy after gynecologic surgery.
OBJECTIVE
Increased interest in laparoendoscopic single-site surgery has instigated research into trials of novel techniques. The procedure we propose may potentially improve patient satisfaction and cosmetic results while diminishing the incidence of trocar-site herniation. We report our initial experience with laparoendoscopic single-site totally extraperitoneal herniorrhaphy for postoperative incisional hernia to determine the procedure's feasibility and safety.


METHODS
Three patients with incisional hernias after gynecologic surgery underwent laparoendoscopic single-site totally extraperitoneal procedures. We evaluated the patients' preoperative and postoperative condition, as well as the details of their original surgery. We performed the procedure through a 2-cm umbilical incision followed by mesh insertion and transabdominal suture placement in all patients.


RESULTS
Laparoendoscopic single-site totally extraperitoneal herniorrhaphy was completed in 80 to 120 minutes. No intraoperative complications were encountered, and surgical blood loss was minimal. The duration of hospital stay ranged from 2 to 4 days. One patient had a postoperative wound infection. The patients have shown no sign of recurrence at 9 months' follow-up.


CONCLUSIONS
Laparoendoscopic single-site totally extraperitoneal herniorrhaphy appears to be feasible and safe. It may be performed with readily available instruments, although further experience and practice are warranted for a more efficient repair. The procedure has similar advantages to a multiport laparoscopic totally extraperitoneal procedure but yields better cosmetic results. More studies are needed to assess the long-term benefits and complications of this procedure.
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
Hsuan
H
Su
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
Lulu
L
Huang
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
Chien-Min
CM
Han
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
Chin-Jung
CJ
Wang
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
Kuan-Gen
KG
Huang
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
Chih-Feng
CF
Yen
D000328:Adult; D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006555:Hernia, Ventral / Q000209:etiology / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D011183:Postoperative Complications
Extraperitoneal approach; Herniorrhaphy; Laparoscopy; Single site