title: First 200 consecutive transumbilical single-incision laparoscopic TEPs.
abstract: Endoscopic pre-peritoneal mesh repair (TEP) through single-incision laparoscopy (SIL) permits placement of a large mesh through a final millimetric umbilical scar. This prospective study evaluates the first 200 consecutive SILTEPs performed by a single surgeon.
  
  
  
  Between November 2011 and September 2015, 200 consecutive SILTEPs were performed in 161 patients. The mean age was 49.8 ± 16.3 years and the mean BMI was 24.5 ± 3.4 kg/m2. The technique involved one 11-mm trocar, one 10-mm 0° scope and curved reusable instruments. A supplementary 1.8-mm straight trocarless grasping forceps was percutaneously inserted for perioperative complications or difficulties.
  
  
  
  A unilateral hernia repair was performed in 122 patients, and a bilateral repair in 39 patients. The total operative time was 57.4 ± 22.3 min, and pure laparoscopic time was 46.6 ± 21.6 min. There was no need for insertion of a supplementary 5-mm trocar, and the need for insertion of 1.8-mm trocarless grasper was 32.9%. Perioperative complications occurred in 73 patients. The mean final scar length was 15.3 ± 2.6 mm. The mean hospital stay was 1.0 ± 0.3 days. Postoperative complications at the access site affected 15 patients and at the hernia site 31 patients. After a mean follow-up of 25.4 ± 12.3 months, there was one asymptomatic, small incisional hernia at the access site as well as one reoperation for recurrent inguinal hernia at 16 months. No other late complications were registered.
  
  
  
  Transumbilical SILTEP permits placement of a large mesh through a final millimetric scar. Getting over the learning curve in conventional multitrocar TEP is mandatory. As per our institute's algorithm, the contraindications continue to be giant inguino-scrotal, incarcerated and recurrent inguinal hernias.
authors.affiliation: Department of Gastrointestinal Surgery, European School of Laparoscopic Surgery, Saint-Pierre University Hospital, Université Libre de Bruxelles, 322, Rue Haute, Brussels, Belgium. giovanni@dapri.net.|Laboratory of Anatomy, Faculty of Medicine and Pharmacy, University of Mons, Mons, Belgium. giovanni@dapri.net.
authors.forename: G
authors.initials: G
authors.lastname: Dapri
authors.affiliation: Department of Gastrointestinal Surgery, European School of Laparoscopic Surgery, Saint-Pierre University Hospital, Université Libre de Bruxelles, 322, Rue Haute, Brussels, Belgium.
authors.forename: L
authors.initials: L
authors.lastname: Gerard
authors.affiliation: Data Centre, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Paesmans
authors.affiliation: Department of Gastrointestinal Surgery, European School of Laparoscopic Surgery, Saint-Pierre University Hospital, Université Libre de Bruxelles, 322, Rue Haute, Brussels, Belgium.
authors.forename: G-B
authors.initials: GB
authors.lastname: Cadière
authors.affiliation: Laboratory of Anatomy, Faculty of Medicine and Pharmacy, University of Mons, Mons, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Saussez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D010537:Peritoneum / Q000601:surgery; D011446:Prospective Studies; D013526:Surgical Mesh; D014472:Umbilicus / Q000601:surgery; D055815:Young Adult
keywords: Inguinal hernia; Laparoscopy; Single incision; Single port; TEP