Characteristics of studies included in our review and meta-analysis
| Characteristic | Cugura et al. (35), (37) | Jacob et al. (38) | Bucher et al. (36) | Surgit et al. (41) | Agrawal et al. (39) | Tran (15) | Do et al. (19) | Chung et al. (42) | He et al. (43) | Tai et al. (44)* | Shih et al. (47) | Kim et al. (46) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| No. of patients | 1 | 3 | 4 | 23 | 16 | 68 | 10 | 100 | 3 | 7 | 30 | 60 |
| Age, yr (range) | 60 | NR | NR | 48.4 (23–67) | 65.5 (21–87) | 44 (18–83) | 43.7 (28–64) | 48 (18–82) | 64.6 (49–73) | 46.5 (21–80)* | NR | 58.5 (24–85) |
| Sex, male:female | 1:0 | 2:1 | — | 18:5 | 16:0 | 66:2 | 10:0 | 85:15 | 3:0 | — | — | 58:2 |
| Surgical technique | ||||||||||||
| Preperitoneal spacemaker | Balloon | Balloon | No balloon | Balloon | No balloon | Balloon | Balloon | Balloon | No balloon | Balloon | Balloon | No balloon |
| Ports | 3 ports via 1 incision | Single port device | Single port device | Single port device | Single port device | Single port device | Single port device | 3 ports via 1 incision | Single port device | 3 ports via 1 incision* | 3 ports via 1 incision | 3 ports via 1 incision |
| Camera | — | 45° | — | 30° | — | 30° | 30° | 30° | 30° | 30°* | 0° | 30° |
| Instruments | Standard straight | Standard straight | Standard straight | Articulating/standard | Standard straight | Curved | Curved/standard | Standard straight | Standard straight | Standard straight* | Curved, manually bent | Standard straight |
| Incision length, cm (range) | 2.5 | 2.5 | Larger than standard TEP | 2 | 3 (2.5–4.5) | 2.5 | 2.8 (2.3–3.2) | 2 | 2 | 1.5* | 2 | 2–2.5 |
| Fixed | Yes | Tacks | — | Tacks | Tacks | Tacks, glue | No fixation | Tacks | — | Tacks* | Tacks | Tacks |
| Duration of surgery; n, min (range) or min ± SD | 60 (52–64) | 64.2 (40–175) | ||||||||||
| Unilateral hernia | n = 1, 90 | NA | n = 3 | n = 19, 48.4 (32–62) | n = 13, 40 (25–75) | n = 36, 50 (35–90) | n = 10, 53.6 (45–65) | n = 83 | NA | 60 | n = 24, 98.3 ± 26.7 | n = 57; indirect: 65.2 (33–150), direct: 52.6 (32–80) |
| Bilateral hernias | NA | n = 3, 79.3 | n = 1 | n = 4, 96.7 (85–120) | n = 3, 70 (60–75) | n = 32, 80 (60–125) | NA | n = 17 | n = 3, 41 (26–65) | 78.5 (52–110) | n = 6, 121.4 ± 13.5 | n = 3, 77 (66–90) |
| Hospital stay, d (range) | 2 | 1, not recorded for 2 patients | — | 1.17 (1–2) | < 1 | 1 overnight patient | 2 | 1.54 (1–11) | 3 | 1.4 | 1.85 | 2.15 |
| Conversion | 0 | 0 | 1, bleeding; 1 extra port inserted | 1, large hernia and adhesions; 2 extra ports inserted | 0 | 1, unable to deploy port; 2 extra ports inserted | 0 | 2, peritoneal tear and adhesions; LESS TAPP performed | 0 | 0 | 0 | 1, omental incarceration, conversion to TAPP |
| Intraoperative complications, no. | 0 | 0 | 1, bleeding | 0 | 0 | — | 0 | 1, peritoneal tear | — | No major complications | 0 | 0 |
| Postoperative recovery | Uneventful | Uneventful | Uneventful | Uneventful | Uneventful | Uneventful | Uneventful | 2 had urinary retention | Uneventful | 1 had ileus and seroma | 2 had seroma | 2: 1 had seroma, 1 had urinary retention |
| Patient satisfaction (scale: 1–5) | — | — | — | — | — | None were dissatisfied | — | — | — | 87.5% satisfied* | — | — |
| Pain | — | — | — | — | n = 1, transient pain in testicle postoperatively | Most patients stopped analgesics within 48 h | No complaints of pain | 5 patients had groin ache | Minimal pain at discharge | — | — | — |
| Return to activity, d | — | — | — | — | — | 7–14 | — | 5.6 (1–30) | — | — | — | — |
| Other follow-up | No wound complications | Early complications: 1 epididymitis, 1 wound infection, 1 wound dehiscience, 11 seroma/haematoma | No wound complications | No wound complications reported | ||||||||
| 2 wk | — | No complications | — | — | — | — | — | — | ||||
| 1 mo | — | n = 1, no complications | — | — | — | — | — | — | ||||
| 2–3 mo | — | — | — | — | n = 2, minor wound complications | — | — | — | ||||
| 10–14 mo | — | — | — | — | — | — | — | — | ||||
| Recurrence, no. | — | None at 2 wk | None at 14 wk | None at 1 mo | None at 2–3 mo | None at 1–10 mo | None at 1 mo | 1 and 10 mo | None at 1 mo | — | None at 6 mo | — |
NR = not reported; SD = standard deviation; TAPP = transabdominal preperitoneal; TEP = totally extraperitoneal.
↵* Results combined with TAPP hernia repairs.