Our Summary

This research paper is about a specific surgical procedure for treating inguinal hernias, which are a type of hernia in the groin area. The procedure is called single-incision laparoscopic totally extraperitoneal hernia repair (SILTEP), which is a minimally invasive surgery that only requires one small incision. This type of surgery is popular because it has good cosmetic results and patients are generally satisfied with the outcomes.

In the study, the researchers looked at the records of 180 patients who had this surgery between 2012 and 2017, all performed by the same surgeon. They wanted to investigate how long it takes for a surgeon to become proficient at this technique, a concept known as the ’learning curve'.

The researchers divided the surgeries into three phases and found that the average time it took for the surgery decreased significantly over the three phases, from about 65 minutes in the first phase to about 35 minutes in the third phase. They also found that the rate of surgical failures, such as needing to make additional incisions or having severe postoperative complications, decreased over time.

In conclusion, the researchers estimated that a skilled laparoscopic surgeon needs to perform about 60 of these surgeries to become proficient and reduce the failure rate to less than 10%. After about 85 surgeries, the surgeon could achieve a stable surgery time of about 35 minutes.

FAQs

  1. What is single-incision laparoscopic totally extraperitoneal hernia repair (SILTEP)?
  2. How many surgeries does a laparoscopic surgeon need to perform to become proficient in SILTEP?
  3. Did the study find a decrease in surgical failures and operation time as the surgeon gained more experience with SILTEP?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laparoscopic hernia repair is to follow their post-operative instructions carefully to ensure proper healing. This may include avoiding heavy lifting or strenuous activities for a certain period of time, taking prescribed pain medications as directed, and attending follow-up appointments with their surgeon. By following these instructions, patients can help reduce the risk of complications and promote a smooth recovery process.

Suitable For

Patients who are typically recommended for single-incision laparoscopic totally extraperitoneal hernia repair (SILTEP) are those with inguinal hernias in the groin area who are looking for a minimally invasive surgical option with good cosmetic results. This procedure is suitable for patients who are generally healthy and do not have significant medical comorbidities that would make them high-risk candidates for surgery. Patients who are motivated to have a faster recovery time and less postoperative pain may also be good candidates for this type of surgery. Additionally, patients who are looking for a shorter surgery time and lower risk of surgical failures may benefit from SILTEP.

Timeline

Before the laparoscopic hernia repair:

  • Patient consults with a healthcare provider and is diagnosed with an inguinal hernia.
  • Patient discusses treatment options with their healthcare provider and decides to undergo laparoscopic hernia repair.
  • Patient may undergo pre-operative testing and preparation for surgery.

After the laparoscopic hernia repair:

  • Patient arrives at the hospital or surgical center on the day of surgery.
  • Patient is prepped for surgery and receives anesthesia.
  • Surgeon makes a small incision and inserts a laparoscope to repair the hernia.
  • Surgery typically lasts between 30-60 minutes.
  • Patient is monitored in the recovery room before being discharged home the same day.
  • Patient may experience some pain, bruising, and swelling in the days following surgery.
  • Patient is advised to avoid heavy lifting and strenuous activities for a few weeks.
  • Follow-up appointments may be scheduled to monitor recovery and ensure the hernia has been successfully repaired.

What to Ask Your Doctor

Some questions a patient should ask their doctor about laparoscopic hernia repair include:

  1. What are the potential risks and complications associated with this surgery?
  2. How long will the recovery process take, and what can I expect in terms of pain management?
  3. How experienced are you in performing laparoscopic hernia repair surgeries?
  4. Are there any alternative treatment options available for my hernia?
  5. What type of anesthesia will be used during the surgery?
  6. Will I need to stay overnight in the hospital after the surgery?
  7. How soon can I return to work and normal activities after the surgery?
  8. Will I need to follow any specific post-operative care instructions or restrictions?
  9. What is the success rate of this surgery for treating inguinal hernias?
  10. Are there any long-term effects or considerations I should be aware of following the surgery?

Reference

Authors: Park YY, Lee K, Oh ST, Lee J. Journal: Hernia. 2022 Jun;26(3):959-966. doi: 10.1007/s10029-021-02431-7. Epub 2021 Jun 7. PMID: 34097186