A new technique for extraperitoneal repair of inguinal hernia

BackgroundOpen inguinal hernia repair (OIHR) carries serious risks without providing contralateral visualization.MethodsWe compared OIHR (n = 363) with single-port laparoscopic extracorporeal hernia ligation with a modified cannula (SLELmc; n = 1514), in which the processus vaginalis (PV) was ligated extracorporeally with our modified cannula via the umbilicus.ResultsOperating times were shorter with SLELmc than with OIHR (unilateral and bilateral, P < 0.001). SLELmc enabled immediate closure of a contralateral patent PV in 143 cases. An incarcerated hernia was present in 45 of 1514 SLELmc patients (3.0%) and 7 of 363 OIHR patients (19.4%). All patients were discharged uneventfully 12-48 h postoperatively, with similar mean follow-up periods (SLELmc, 40.3 ± 6.4 mo versus OIHR 41.0 ± 7.5 mo; P = 0.071). The incidence of complications was lower after SLELmc (59 of 1514; 3.9%) than OIHR (82 of 363; 22.6%; P < 0.001).ConclusionsSLELmc enables fast, effective PV closure and permits detection of concealed hernias.