Comparison of single-incision totally extraperitoneal repair of inguinal hernia and conventional multi-port totally extraperitoneal repair: A retrospective study.

INTRODUCTION

Mesh-based repair is the standard treatment of inguinal hernias. Transabdominal preperitoneal repair and totally extraperitoneal (TEP) repair are the established laparoendoscopic techniques. Although TEP avoids intra-abdominal access, technical difficulty limits its adoption. Single-incision laparoscopic surgery (SILS) offers cosmetic and potential clinical advantages. However, evidence comparing SILS-TEP with conventional three-port TEP remains limited. This study aimed to evaluate the feasibility, safety and clinical outcomes of SILS-TEP compared with those of three-port TEP for inguinal hernia repair.

PATIENTS AND

METHODS

We retrospectively reviewed adult patients who underwent TEP hernia repair at our institute between April 2022 and June 2025. Patients were divided into SILS-TEP and three-port TEP groups. Demographics, hernia classification, operative details, pain, complications and recovery outcomes were analysed. Acute pain was assessed by post-operative analgesic use and chronic pain was defined as pain persisting for more than 3 months. Statistical significance was set at P < 0.05.

RESULTS

A total of 102 patients (62 SILS-TEP, 40 3-port TEP) were evaluated. Patient characteristics and hernia types were similar between the groups. The operative time was significantly shorter in the SILS-TEP group than in the three-port TEP group (57.4 min vs. 70.3 min, P = 0.007). No differences were observed in analgesic use, complications or hospitalisation. No conversions, chronic pain or hernia recurrence were reported in either group.

CONCLUSION

SILS-TEP was safely performed without compromising surgical quality. It demonstrated a shorter operative time and equivalent clinical outcomes compared to three-port TEP. SILS-TEP may be a feasible and cosmetically superior alternative for inguinal hernia repair.