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Needlescopic inguinal hernia repair in children
1Surgical Department, Al-Azhar and Ain Shams University, Cairo, Egypt.
Insights
Needlescopic surgery offers a minimally invasive approach for pediatric inguinal hernia (IH) repair. This technique is effective, easy to perform, and allows for the detection of hidden contralateral hernias.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Laparoscopy
Background:
- Inguinal hernia (IH) is a common condition in children.
- Traditional open surgery for IH can have limitations.
- Minimally invasive techniques are being explored for improved outcomes.
Purpose of the Study:
- To evaluate the efficacy and outcomes of needlescopy for pediatric inguinal hernia repair.
- To compare needlescopic herniotomy with open surgical methods.
- To assess the diagnostic capability of laparoscopy for contralateral hernias.
Main Methods:
- A study of 150 children undergoing needlescopic herniotomy for IH.
- Utilized a 2.7-mm telescope and 2-mm needle holders for internal ring closure.
- Suturing with 4/0 PDS to close the internal ring.
Main Results:
- Mean operative time was 20.6 min (unilateral) and 26.4 min (bilateral).
- Mean hospital stay was 18 hours.
- Needlescopy successfully diagnosed hidden contralateral hernias in 8% of cases.
Conclusions:
- Needlescopic closure of the internal ring in children is a feasible and advantageous surgical option.
- Laparoscopic approach offers benefits over open surgery for pediatric inguinal hernias.
- The ability to detect contralateral hernias is a significant advantage of this technique.
Abstract:
The object of the present study was to assess the value and outcome of needlescopy in the treatment of inguinal hernia (IH) in 150 children operated upon in Al-Mishary Hospital, Riyadh, between October 1997 and October 1999. Their ages ranged between 6 and 96 months, (mean 61.6 +/- 28.32 months). There were 130 males and 20 females; 81 (54%) presented with a right-sided IH and among these patients a hidden contralateral hernia was diagnosed in 12 cases (8%). A left-sided IH was present in 30 (20%) bilateral IHs in 19 cases (12.66%), a recurrent hernia in 15 (10%), and an incarcerated hernia in 5 (3.33%). All patients were subjected to needlescopic herniotomy using a 2.7-mm telescope and two 2-mm needle holders to close the internal ring with a 4/0 PDS suture. The mean duration of surgery was 20.6 +/- 4.65 min for unilateral and 26.4 +/- 1.6 min for bilateral hernia repair. The mean hospital stay was 18 +/- 3.23 h. The study showed that laparoscopic closure of the internal ring in children is feasible, easy, and preferable to open surgery. The fact that laparoscopy can diagnose a hidden contralateral hernia is an additional advantage.