Feasibility and safety of laparoendoscopic single-site surgery of total extraperitoneal inguinal hernia repair after previous open groin hernia repair: a comparative study

Background: This study is aimed at evaluating the feasibility and safety of laparoendoscopic single-site surgery (LESS) for totally extraperitoneal (TEP) endoscopic hernia surgery after previous open groin hernia repair that may hamper preperitoneal dissection. Methods: This prospective cohort study included 213 consecutive patients undergoing LESS TEP hernia repair between January 2009 and December 2013. The study group consisted of 36 patients with a history of previous open inguinal hernia repair before undergoing LESS TEP hernia repair. The study enrolled the other 177 patients who underwent LESS TEP during the same period and were enrolled as the control group. We obtained perioperative data for all patients including demographic data, operation time, length of hospital stay, narcotic dose, conversions, and complications. Results: A total of 213 patients with inguinal hernia underwent LESS TEP repair. One case in the control group (0.56 %) required conversion to LESS transabdominal preperitoneal hernia repair, while no cases in the study group required conversion. We observed no differences between the two groups in terms of operative time, analgesic use, hospital stay, and postoperative complications. Conclusions: LESS TEP hernia repair for patients with previous open inguinal hernia repair can be performed safely by experienced surgeons. Operative outcomes were comparable between both the primary inguinal and recurrent hernia groups.