title: Single-port versus conventional laparoscopic total extra-peritoneal inguinal hernia repair: a prospective, randomized, controlled clinical trial.
abstract: BACKGROUND
  The advantage of single-port total extra-peritoneal (TEP) inguinal hernia repair over the conventional technique is still debatable. Our objective was to compare the outcomes of TEP inguinal hernia repair using either a single-port or conventional surgical technique, in two blind randomized groups of patients.
  
  
  METHODS
  In this prospective, randomized, double-blind, controlled clinical trial, 100 patients undergoing surgery for unilateral inguinal hernia were randomized into two groups: One group underwent conventional laparoscopic TEP inguinal hernia repair, while the other was selected for single-port TEP repair. Primary endpoint is postoperative pain (VAS), while secondary endpoints are recurrence, chronic pain and complications.
  
  
  RESULTS
  From 100 patients, 49 underwent single-port hernia TEP repair, 50 had conventional three-port TEP hernia repair, and one patient declined to participate after randomization. The two groups were comparable in terms of patient demographics and operative findings. Mean operative time was 49.1(±13.8) min in the conventional group and 54.1(±14.4) min in the single-port group (p = 0.08). Mean hospital stay was 19.7(±5.8) h in the conventional group and 20.5(±6.4) h in the single-port group (p = 0.489). No major complications and no recurrence reported at 11-month follow-up. No statistically significant difference noted in postoperative pain between the two groups at regular intervals.
  
  
  CONCLUSIONS
  The outcomes after laparoscopic TEP inguinal hernia repair with a single-port device are similar but not superior to the conventional technique.
authors.affiliation: Department of Surgery, Minimally Invasive Surgical Centre, National University Health System, Singapore, Singapore. sujithwijerathne@gmail.com.|Department of General Surgery, National University Health System, NUHS Tower Block, Level 08, 1E, Kent Ridge Road, Singapore, 119228, Singapore. sujithwijerathne@gmail.com.
authors.forename: Sujith
authors.initials: S
authors.lastname: Wijerathne
authors.affiliation: Department of Surgery, Minimally Invasive Surgical Centre, National University Health System, Singapore, Singapore.
authors.forename: Narendra
authors.initials: N
authors.lastname: Agarwal
authors.affiliation: Department of Surgery, Minimally Invasive Surgical Centre, National University Health System, Singapore, Singapore.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Ramzi
authors.affiliation: Department of Surgery, Minimally Invasive Surgical Centre, National University Health System, Singapore, Singapore.
authors.forename: Dino H
authors.initials: DH
authors.lastname: Liem
authors.affiliation: Department of Surgery, Minimally Invasive Surgical Centre, National University Health System, Singapore, Singapore.
authors.forename: Wee B
authors.initials: WB
authors.lastname: Tan
authors.affiliation: Department of Surgery, Minimally Invasive Surgical Centre, National University Health System, Singapore, Singapore.
authors.forename: Davide
authors.initials: D
authors.lastname: Lomanto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004311:Double-Blind Method; D004867:Equipment Design; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010537:Peritoneum / Q000601:surgery; D011446:Prospective Studies; D055815:Young Adult
keywords: Inguinal hernia; Randomized trial; Single port; Total extra-peritoneal (TEP)