Laparoendoscopic Single-Site Herniorrhaphy After Gynecologic Surgery

BACKGROUND AND OBJECTIVES: 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. CONCLUSION: 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.