Single-incision Laparoscopic Versus Conventional Laparoscopic Ventral Hernia Repair: A Comparison of Short-term Surgical Results

Aim: To demonstrate the feasibility of single-port incisional hernia repair, quantify incision size, and compare results of patients operated by standard laparoscopy (SL) with those operated by the single-port technique [laparoendoscopic single-site surgery (LESS)]. Methods: Prospective data collected on patients operated from March 2008 to June 2010. Indication for surgery was incisional hernia > 3cm. There were no selection criteria for the enrollment of patients or the operative technique used. Results: Thirty-four patients were operated (18 women and 16 men): 15 with LESS and 19 with SL. There was no difference for age, body mass index, ASA scores, or number of previous surgical procedures. LESS patients had slightly larger (82 +/- 54 vs. 64 +/- 34 mm) and more numerous hernias: 3 (1 to 7) versus 1 (1 to 3). Adhesion grades, severity scores, and operating times (78.2 SD +/- 31.2 vs. 73.5 SD +/- 25.4 min, P = 0.76) did not differ between the groups. The mean fascia incision size in LESS was digitally measured as 12.93 +/- 2.01 mm. The hospital stay was a median of 1 day in both groups. There was 1 conversion in the SL group. The median follow-up time was 26 months (range, 25 to 31 mo) for LESS and 34 months (range, 31 to 42 mo) for SL. Complications: There were 2 seromas and 1 hematoma in the LESS group. In the SL group, there were 2 small-bowel injuries and 2 seromas. There were no recurrences in the SL group, 1 in LESS, and no port-site hernia so far. Conclusions: LESS incisional hernia repair through 1 minimal fascia incision is feasible. Early results do not indicate a longer operation time, higher complication, or higher recurrence rates.