Single incision laparoscopic totally extraperitoneal inguinal hernia repair

Various single incision laparoscopic surgeries (SILS) and natural orifice transluminal endoscopic surgeries (NOTES) have been reported recently. Herein we performed SILS for totally extraperitoneal inguinal hernia repair (TEP) on three cases. Three males of 72, 49, and 73 years old with the diagnoses of bilateral primary inguinal hernia underwent single incision TEP. The operative steps of single incision TEP are very similar to those of a traditional laparoscopic TEP. The difference between them is a 2 cm infraumbilical incision for the placement of three (5 mm) trocars in single incision TEP. We preferred to use a 30A degrees 5 mm laparoscope with some routine laparoscopic instruments during the surgical procedure. All the hernia defects were repaired with VyproII of 15 x 10 cm (Ethicon, NJ, USA). The operations took 32, 26, and 65 min, respectively, with no obvious inconvenience. All three patients were discharged on the second postoperative day uneventfully. The postoperative follow-up showed no recurrence in the three patients up to now. The single incision TEP using an access port device is safe and feasible. Meanwhile SILS may reduce medical costs and complication rates through practice and improvement of SILS instruments.