SINGLE PORT VS.

STANDARD LAPAROSCOPIC VENTRAL HERNIA

REPAIR. A PROSPECTIVE ANALYSIS.

Christensen AC ,Spasojevic MS, Nesgaard JM , Pettersen MP , Ignjatovic DI

Vestfold Hospital, Tonsberg , Norway
Aim: to compare results of patients operated for incisional hernia through standard laparoscopy (SL) with those operated through a single port technique (LESS).
Methods: Prospective data collection on patients operated from March 2008 to December 2009. Indication for surgery was incisional hernia larger than 3 cm. All
procedures were performed by a single surgeon (DI). There was no selection criteria to the enrollment of patients or operative technique used. Hernia size and
number were noted at surgery, adhesions were graded according to Zuelke et al. Adhesion surface was graded according to number of abdominal quadrants occupied.
Adhesion severity score was calculated as grade x surface. Results: 33 patients were operated 17 women, 16 men, 15 LESS and 18 SL. There was no statistical
significant difference for age (60 and 63 yrs, p=0.44), BMI (30.3SD±6,3 and 28.9SD±5,2, p=0,76), ASA scores (2.5SD±0,7 and 2,4SD±0,7, p=0,58), and mean number of
previous surgical procedures (2,13 (range 0-6) and 2,27 (range 0-7), p=0,84), respectively. Hernia size was smaller in the SL group (6.4SD+3.4 vs. 8.2SD+5.4, p=0.38).
The number of hernias verified at surgery was 2.7 (range1-7) in LESS and 1.3 (range 1-3) in SL, p=0.09. Mean adhesion grades and severity scores were 2.8SD±1.4 and
6.1SD±5.0 vs. 2.8 SD±0.99 and 7.1SD±3.8, p=0.58 and p=0.36, respectively. Operating times were insignificantly longer in LESS (78.2SD±31.2 vs. 73.5SD±25.4, p=0.76).
Hospital stay was median 1day in both groups (1-14 and 1-21, respectively, p=0.71). There was one conversion in the SL group. Complications: 2 seromas and 1
hematoma in LESS, 2 small bowel injuries, 2 seroma in SL. No recurrences or port site hernia so far. Conclusions: LESS incisional hernia repair is feasible without longer
operation times, higher complication or recurrence rates.
Fig 2:View from
within the port.
The fascia opening
Is 10 mm. The ribbon
on the left hand side
is 9 mm.

Fig 1:Patient operated

for a large incisional
hernia after
aorta surgery, a
MESH 20 x 30 cm
was placed