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Nanoscopic Single-Incision Anterior Labrum Repair.

ABSTRACT: Arthroscopy frequently has been used to treat a variety of shoulder conditions, including anterior labrum tears. Anterior labrum repair techniques have progressed from multiple incision techniques to most recently a single anterior working portal with a posterior viewing portal. With the development of the NanoScope (Arthrex, Naples, FL), we do not need to make a standard portal for viewing purposes. In this article, we describe the single-incision anterior labrum repair bypassing the need for a posterior skin incision. The removal of this incision and portal should result in less fluid needed and less swelling. We hope this leads to less pain and improved patient outcomes.

SUBMITTER: Lavender C

PROVIDER: S-EPMC7093698 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:IntroductionSpigelian hernias represent only 1% to 2% of all abdominal wall hernias. The treatment, however, remains controversial but depends on institutional expertise. This case series reports the first experience with single-incision laparoscopic totally extraperitoneal (SILTEP) repair of Spigelian hernias with telescopic extraperitoneal dissection in combination with inguinal hernia repair.MethodsFrom February 2013 to April 2014, all patients referred with inguinal or Spigelian hernias, without histories of extraperitoneal intervention, underwent SILTEP repair with telescopic extraperitoneal dissection. A single-port device, 5.5 mm/52 cm/30° angled laparoscope, and conventional straight dissecting instruments were used for all cases. Extraperitoneal dissection was performed under direct vision with preservation of preperitoneal fascia overlying retroperitoneal nerves. Inguinal herniorrhaphy was performed with lightweight mesh that covered low-lying Spigelian defects. High-lying Spigelian defects were repaired with additional mesh.ResultsThere were 131 patients with 186 (92 direct) inguinal hernias and 7 patients with 8 Spigelian hernias (6 incidental, including 1 bilateral and 2 preoperatively diagnosed), with a mean age of 51.3 years and a mean body mass index of 25.1 kg/m(2). An additional piece of mesh was used for 3 hernias. All Spigelian hernias were associated with direct inguinal hernias, and 8 combined inguinal and Spigelian hernias were successfully repaired with SILTEP repair with telescopic extraperitoneal dissection as day cases. There were no clinical recurrences during a mean follow-up period of 6 months (range, 1-15 months).ConclusionsCombined Spigelian and inguinal hernias can be successfully treated with SILTEP herniorrhaphy with telescopic extraperitoneal dissection. The high incidence of Spigelian hernias associated with direct inguinal hernias suggests a high index of suspicion for Spigelian hernias during laparoscopic inguinal herniorrhaphy.

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Nanoscopic Single-Incision Anterior Labrum Repair.

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