Patient related outcomes and ergonomic evaluation of triangular 3-port or ‘two-hand’ TEP hernioplasty: a preliminary analysis in a university hospital


  • Awanish Kumar Department of Surgery, King George’s Medical University, Uttar Pradesh, India
  • Avtar Pauchari Department of Surgery, King George’s Medical University, Uttar Pradesh, India
  • Akshay Anand Department of Surgery, King George’s Medical University, Uttar Pradesh, India
  • Abhinav Arun Sonkar Department of Surgery, King George’s Medical University, Uttar Pradesh, India



Hernioplasty, TEP, Two hand technique, Triangular 3-port


Background: Standard TEP technique requires three skin incisions for placement of three trocars in the midline. This can be done by 3 port triangular technique or two-hand technique. This study reports a preliminary analysis of peri-operative outcomes and ergonomics characteristics of this procedure in our setup.

Methods: N=10 patients underwent triangular 3 port technique or two-hand TEP hernioplasty after informed written consent in Department of Surgery, King George’s Medical University UP between January to June 2016 after institutional ethical approval. Patient related outcomes in terms of quality of life (QOL) and ergonomic evaluation of the technique have been reported in this study.

Results: The mean duration of surgery was 79.4±4.5 minutes with duration of hospital stay 2.4±0.5 days. The time to return to routine work was 1.0±0.2 days and office work was 4.0±1.8 days. Hernioplasty related QOL calculated using Carolina comfort scale showed improved with increased follow up period. Ergonomically the procedure can be safely performed without added stress on the surgeon.

Conclusions: ‘Two-hand approach’ or triangular 3-port TEP hernioplasty is ergonomically feasible and enables a surgeon to perform surgery safely using basic principles of laparoscopy.


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