Single-incision laparoscopic totally extraperitoneal inguinal hernia repair with tumescent local anesthesia: report of more than 2000 procedures at a day-surgery clinic
Purpose The purpose of this study was to evaluate the feasibility and safety of single-incision laparoscopic surgery for totally extraperitoneal inguinal hernia repair (SILS-TEP) with tumescent local anesthesia (TLA) at a day-surgery clinic. Methods We analyzed, retrospectively, 2148 patients who un...
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| Published in | Surgery today (Tokyo, Japan) Vol. 51; no. 4; pp. 545 - 549 |
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| Main Authors | , , |
| Format | Journal Article |
| Language | English |
| Published |
Singapore
Springer Singapore
01.04.2021
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0941-1291 1436-2813 1436-2813 |
| DOI | 10.1007/s00595-020-02141-0 |
Cover
| Abstract | Purpose
The purpose of this study was to evaluate the feasibility and safety of single-incision laparoscopic surgery for totally extraperitoneal inguinal hernia repair (SILS-TEP) with tumescent local anesthesia (TLA) at a day-surgery clinic.
Methods
We analyzed, retrospectively, 2148 patients who underwent SILS-TEP under general anesthesia with TLA between April, 2015 and March, 2020 at Gi surgical clinic, to evaluate their operative outcomes. The TLA agent, consisting of normal saline and lidocaine with epinephrine and ropivacaine, was injected during surgery.
Results
The median operative times for unilateral and bilateral hernia were 50 min and 75 min, respectively. Blood loss was minimal in all patients. Conversion to the Lichtenstein method was required in 4% (91/2148) of patients. The median recovery room stay was 125 min and no analgesics were required in the recovery room by 75% (1613/2148) of the patients. All the patients left the clinic on the day of surgery. Complications developed in 6.5% (139/2148) of the patients, as seromas in 6% (125/2148), wound infections in 0.4% (8/2148), and hematomas in 0.2% (4/2148), respectively. Bowel injury and obstruction each occurred in 0.05% (1/2148) of the patients. There were no hernia recurrences.
Conclusion
SILS-TEP with TLA can be performed safely at a day-surgery clinic. |
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| AbstractList | The purpose of this study was to evaluate the feasibility and safety of single-incision laparoscopic surgery for totally extraperitoneal inguinal hernia repair (SILS-TEP) with tumescent local anesthesia (TLA) at a day-surgery clinic.
We analyzed, retrospectively, 2148 patients who underwent SILS-TEP under general anesthesia with TLA between April, 2015 and March, 2020 at Gi surgical clinic, to evaluate their operative outcomes. The TLA agent, consisting of normal saline and lidocaine with epinephrine and ropivacaine, was injected during surgery.
The median operative times for unilateral and bilateral hernia were 50 min and 75 min, respectively. Blood loss was minimal in all patients. Conversion to the Lichtenstein method was required in 4% (91/2148) of patients. The median recovery room stay was 125 min and no analgesics were required in the recovery room by 75% (1613/2148) of the patients. All the patients left the clinic on the day of surgery. Complications developed in 6.5% (139/2148) of the patients, as seromas in 6% (125/2148), wound infections in 0.4% (8/2148), and hematomas in 0.2% (4/2148), respectively. Bowel injury and obstruction each occurred in 0.05% (1/2148) of the patients. There were no hernia recurrences.
SILS-TEP with TLA can be performed safely at a day-surgery clinic. Purpose The purpose of this study was to evaluate the feasibility and safety of single-incision laparoscopic surgery for totally extraperitoneal inguinal hernia repair (SILS-TEP) with tumescent local anesthesia (TLA) at a day-surgery clinic. Methods We analyzed, retrospectively, 2148 patients who underwent SILS-TEP under general anesthesia with TLA between April, 2015 and March, 2020 at Gi surgical clinic, to evaluate their operative outcomes. The TLA agent, consisting of normal saline and lidocaine with epinephrine and ropivacaine, was injected during surgery. Results The median operative times for unilateral and bilateral hernia were 50 min and 75 min, respectively. Blood loss was minimal in all patients. Conversion to the Lichtenstein method was required in 4% (91/2148) of patients. The median recovery room stay was 125 min and no analgesics were required in the recovery room by 75% (1613/2148) of the patients. All the patients left the clinic on the day of surgery. Complications developed in 6.5% (139/2148) of the patients, as seromas in 6% (125/2148), wound infections in 0.4% (8/2148), and hematomas in 0.2% (4/2148), respectively. Bowel injury and obstruction each occurred in 0.05% (1/2148) of the patients. There were no hernia recurrences. Conclusion SILS-TEP with TLA can be performed safely at a day-surgery clinic. The purpose of this study was to evaluate the feasibility and safety of single-incision laparoscopic surgery for totally extraperitoneal inguinal hernia repair (SILS-TEP) with tumescent local anesthesia (TLA) at a day-surgery clinic.PURPOSEThe purpose of this study was to evaluate the feasibility and safety of single-incision laparoscopic surgery for totally extraperitoneal inguinal hernia repair (SILS-TEP) with tumescent local anesthesia (TLA) at a day-surgery clinic.We analyzed, retrospectively, 2148 patients who underwent SILS-TEP under general anesthesia with TLA between April, 2015 and March, 2020 at Gi surgical clinic, to evaluate their operative outcomes. The TLA agent, consisting of normal saline and lidocaine with epinephrine and ropivacaine, was injected during surgery.METHODSWe analyzed, retrospectively, 2148 patients who underwent SILS-TEP under general anesthesia with TLA between April, 2015 and March, 2020 at Gi surgical clinic, to evaluate their operative outcomes. The TLA agent, consisting of normal saline and lidocaine with epinephrine and ropivacaine, was injected during surgery.The median operative times for unilateral and bilateral hernia were 50 min and 75 min, respectively. Blood loss was minimal in all patients. Conversion to the Lichtenstein method was required in 4% (91/2148) of patients. The median recovery room stay was 125 min and no analgesics were required in the recovery room by 75% (1613/2148) of the patients. All the patients left the clinic on the day of surgery. Complications developed in 6.5% (139/2148) of the patients, as seromas in 6% (125/2148), wound infections in 0.4% (8/2148), and hematomas in 0.2% (4/2148), respectively. Bowel injury and obstruction each occurred in 0.05% (1/2148) of the patients. There were no hernia recurrences.RESULTSThe median operative times for unilateral and bilateral hernia were 50 min and 75 min, respectively. Blood loss was minimal in all patients. Conversion to the Lichtenstein method was required in 4% (91/2148) of patients. The median recovery room stay was 125 min and no analgesics were required in the recovery room by 75% (1613/2148) of the patients. All the patients left the clinic on the day of surgery. Complications developed in 6.5% (139/2148) of the patients, as seromas in 6% (125/2148), wound infections in 0.4% (8/2148), and hematomas in 0.2% (4/2148), respectively. Bowel injury and obstruction each occurred in 0.05% (1/2148) of the patients. There were no hernia recurrences.SILS-TEP with TLA can be performed safely at a day-surgery clinic.CONCLUSIONSILS-TEP with TLA can be performed safely at a day-surgery clinic. |
| Author | Wakasugi, Masaki Hasegawa, Junichi Ikeda, Yoshihiro |
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| Cites_doi | 10.1007/s00595-016-1376-7 10.1097/SLE.0000000000000346 10.1016/j.amjsurg.2008.11.045 10.1097/01.sla.0000133083.54934.ae 10.1097/00000658-195009000-00020 10.1111/ases.12368 10.1007/s00595-016-1349-x 10.1177/074880688700400403 |
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| Keywords | Tumescent local anesthesia (TLA) Day surgery Totally extraperitoneal repair (TEP) Inguinal hernia Single-incision laparoscopic surgery (SILS) |
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| References | Potts, Riker, Lewis (CR7) 1950; 132 Wakasugi, Suzuki, Tei, Anno, Mikami, Tsukada (CR2) 2017; 47 Klein (CR10) 1987; 4 Wakasugi, Tei, Akamatsu (CR1) 2016; 26 Dindo, Demartines, Clavien (CR9) 2004; 240 Clavien, Sanabria, Strasberg (CR8) 1992; 111 Wakasugi, Tei, Suzuki, Furukawa, Masuzawa, Kishi (CR3) 2017; 10 Lichtenstein, Shulman (CR6) 1986; 71 Tokumura, Nomura, Saijo, Matsumura, Yasumoto, Muto (CR5) 2017; 47 Narita, Sakano, Okamoto, Uemoto, Yamamoto (CR4) 2009; 198 D Dindo (2141_CR9) 2004; 240 M Wakasugi (2141_CR1) 2016; 26 M Wakasugi (2141_CR2) 2017; 47 IL Lichtenstein (2141_CR6) 1986; 71 PA Clavien (2141_CR8) 1992; 111 M Wakasugi (2141_CR3) 2017; 10 H Tokumura (2141_CR5) 2017; 47 M Narita (2141_CR4) 2009; 198 WJ Potts (2141_CR7) 1950; 132 JA Klein (2141_CR10) 1987; 4 |
| References_xml | – volume: 47 start-page: 307 year: 2017 end-page: 312 ident: CR2 article-title: The feasibility and safety of single-incision totally extraperitoneal inguinal hernia repair after previous lower abdominal surgery: 350 procedures at a single center publication-title: Surg Today doi: 10.1007/s00595-016-1376-7 – volume: 26 start-page: e149 year: 2016 end-page: e152 ident: CR1 article-title: Single-incision totally extraperitoneal inguinal hernia repair after previous inguinal hernia repair publication-title: Surg Laparosc Endosc Percutan Tech doi: 10.1097/SLE.0000000000000346 – volume: 71 start-page: 1 year: 1986 end-page: 4 ident: CR6 article-title: Ambulatory outpatient hernia surgery. Including a new concept, introducing tension-free repair publication-title: Int Surg. – volume: 198 start-page: e27 year: 2009 end-page: 31 ident: CR4 article-title: Tumescent local anesthesia in inguinal herniorrhaphy with a PROLENE Hernia System: original technique and results publication-title: Am J Surg doi: 10.1016/j.amjsurg.2008.11.045 – volume: 240 start-page: 205 year: 2004 end-page: 213 ident: CR9 article-title: Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey publication-title: Ann Surg doi: 10.1097/01.sla.0000133083.54934.ae – volume: 132 start-page: 566 year: 1950 end-page: 576 ident: CR7 article-title: The treatment of inguinal hernia in infants and children publication-title: Ann Surg doi: 10.1097/00000658-195009000-00020 – volume: 10 start-page: 301 year: 2017 end-page: 307 ident: CR3 article-title: Single-incision totally extraperitoneal inguinal hernia repair is feasible and safe in patients on antithrombotic therapy: a single-center experience of 92 procedures publication-title: Asian J Endosc Surg doi: 10.1111/ases.12368 – volume: 111 start-page: 518 year: 1992 end-page: 526 ident: CR8 article-title: Proposed classification of complications of surgery with examples of utility in cholecystectomy publication-title: Surgery – volume: 47 start-page: 52 year: 2017 end-page: 57 ident: CR5 article-title: Tumescent TAPP: laparoscopic inguinal hernia repair after the preperitoneal tumescent injection of diluted lidocaine and epinephrine saline solution and carbon dioxide gas publication-title: Surg Today doi: 10.1007/s00595-016-1349-x – volume: 4 start-page: 263 year: 1987 end-page: 267 ident: CR10 article-title: The tumescent technique for liposuction surgery publication-title: J Am Acad Cosmetic Surg doi: 10.1177/074880688700400403 – volume: 26 start-page: e149 year: 2016 ident: 2141_CR1 publication-title: Surg Laparosc Endosc Percutan Tech doi: 10.1097/SLE.0000000000000346 – volume: 71 start-page: 1 year: 1986 ident: 2141_CR6 publication-title: Int Surg. – volume: 47 start-page: 52 year: 2017 ident: 2141_CR5 publication-title: Surg Today doi: 10.1007/s00595-016-1349-x – volume: 10 start-page: 301 year: 2017 ident: 2141_CR3 publication-title: Asian J Endosc Surg doi: 10.1111/ases.12368 – volume: 240 start-page: 205 year: 2004 ident: 2141_CR9 publication-title: Ann Surg doi: 10.1097/01.sla.0000133083.54934.ae – volume: 4 start-page: 263 year: 1987 ident: 2141_CR10 publication-title: J Am Acad Cosmetic Surg doi: 10.1177/074880688700400403 – volume: 198 start-page: e27 year: 2009 ident: 2141_CR4 publication-title: Am J Surg doi: 10.1016/j.amjsurg.2008.11.045 – volume: 132 start-page: 566 year: 1950 ident: 2141_CR7 publication-title: Ann Surg doi: 10.1097/00000658-195009000-00020 – volume: 111 start-page: 518 year: 1992 ident: 2141_CR8 publication-title: Surgery – volume: 47 start-page: 307 year: 2017 ident: 2141_CR2 publication-title: Surg Today doi: 10.1007/s00595-016-1376-7 |
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The purpose of this study was to evaluate the feasibility and safety of single-incision laparoscopic surgery for totally extraperitoneal inguinal... The purpose of this study was to evaluate the feasibility and safety of single-incision laparoscopic surgery for totally extraperitoneal inguinal hernia repair... |
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| Title | Single-incision laparoscopic totally extraperitoneal inguinal hernia repair with tumescent local anesthesia: report of more than 2000 procedures at a day-surgery clinic |
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