Single-incision totally extraperitoneal inguinal hernia repair is safe and feasible in elderly patients: A single-center experience of 365 procedures

The aim of this study was to evaluate the feasibility and safety of SILS for totally extraperitoneal inguinal hernia repair in elderly patients. A retrospective analysis of 365 patients who underwent of SILS for totally extraperitoneal inguinal hernia repair from January 2012 to November 2015 at Osaka Police Hospital was performed, and the outcomes of patients aged<80years and those aged80years were compared. There was a greater proportion of patients with an ASA score3 among those80years than among those<80years. The mean operative time for unilateral inguinal hernia was 94min in patients<80years and 98min in patients80years. The mean operative time for bilateral inguinal hernia was 133min in patients<80years and 130min in patients80. Intraoperative bleeding was minimal in all patients. Conversion to a different operative procedure occurred in 3% (10/322) of patients<80years and in 5% (2/43) of patients80years (P=0.6). The mean postoperative hospital stay was 2.2days for patients<80years and 2.2days for patients80years. The mean follow-up period 21 +/- 14months (range, 3-50 months) for patients<80years and 17 +/- 14months (range, 3-50 months) for patients80years (P=0.3). Postoperative complications were seen in 12% (38/322) of patients<80years and in 14% (6/43) of patients80years (P=0.7). A seroma was seen in 9% (28/322) of patients<80years and in 12% (5/43) of patients80years (P=0.6). A wound infection occurred in 2% (8/322) of patients<80years. These seromas and wound infections were managed conservatively. Pulmonary embolism was seen in one patient <80years (0.3%). There was no mortality or recurrence in either group. SILS for totally extraperitoneal inguinal hernia repair has good cosmesis and can be performed in elderly patients with acceptable morbidity and mortality.