Hernia Surgery

Abstract

Although described by Kelling G in 1901, the field of laparoscopic or minimally invasive surgery did not gain wide spread use until the advent of the transistor chip and a video camera attached to the end of the laparoscope was invented. As video imaging systems and new instruments continue to develop, single-incision laparoscopic surgery (SILS) has recently been a focus for active investigation in the surgical field. Potential advantages over conventional laparoscopic surgery include better cosmetic results, less postoperative wound pain, and less port site complications, which have yet to be validated by prospective comparative studies. Transumbilical single-incision laparoscopic cholecystectomy and appendectomy are among the most commonly described SILS procedures with various techniques having been reported in the literature. More recently, herniorrhaphy for inguinal hernia by SILS approach has also been reported in both adult and pediatric patients (Tai et al., Surg Endosc 25:2879–2883, 2011; Cugura et al., J Endourol 26:63–66, 2012; Muensterer and Georgeson, Surg Endosc 25:3438–3439, 2011; Kim et al., J Korean Surg Soc 81:339–343, 2011). The initial experience shows that SILS herniorrhaphy for inguinal hernia is technically feasible with satisfied outcomes. Technical challenges, including triangulation, inline vision, and clashing of instruments, were the most salient and frustrating aspect during the procedure. The short-term results have shown that in experienced hands, inguinal hernia repair with SILS technique could be as safe as the standard technique. However, long-term follow-up with larger trials and more sensitive evaluation tools are needed to confirm the initial experience.