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Inguinal hernia repair in children using single-incision laparoscopic-assisted percutaneous extraperitoneal closure
Hiroo Uchida1, Hiroshi Kawashima, Chikashi Goto
1Department of Pediatric Surgery, Saitama Children's Medical Center, Saitama 339-8551, Japan. uchida.hiroo@pref.saitama.lg.jp
Insights
Single-incision laparoscopic percutaneous extraperitoneal closure (SILPEC) is a safe and feasible technique for pediatric inguinal hernias. This method offers excellent cosmetic results compared to conventional laparoscopic percutaneous extraperitoneal closure (LPEC).
Area of Science:
- Pediatric surgery
- Minimally invasive surgery
- Laparoscopic surgery
Background:
- Laparoscopic percutaneous extraperitoneal closure (LPEC) is a reliable method for pediatric inguinal hernias.
- Single-incision laparoscopic surgery (SILS) aims to further reduce invasiveness.
- Assessing the safety and feasibility of SILS for LPEC is crucial.
Purpose of the Study:
- To evaluate the safety and feasibility of single-incision laparoscopic percutaneous extraperitoneal closure (SILPEC).
- To compare SILPEC with conventional laparoscopic percutaneous extraperitoneal closure (LPEC) in pediatric patients.
Main Methods:
- A comparative study involving 177 children undergoing either LPEC (117) or SILPEC (60).
- Procedures were performed between June 2009 and March 2010.
- Key outcomes included visualization, tissue manipulation, complications, recurrence, and cosmetic results.
Main Results:
- Both LPEC and SILPEC demonstrated good visualization and tissue manipulation.
- No complications or early recurrences were observed in either group.
- SILPEC offered superior cosmetic outcomes due to scar concealment within the umbilicus.
Conclusions:
- Single-incision LPEC (SILPEC) is a safe and feasible surgical option for pediatric inguinal hernias.
- SILPEC achieves comparable success rates to conventional LPEC.
- SILPEC provides excellent cosmetic results, enhancing patient satisfaction.
Background/Purpose:
There are numerous techniques of minimally invasive surgery for pediatric inguinal hernia. However, laparoscopic percutaneous extraperitoneal closure (LPEC) is one of the most simple and reliable methods. Single-incision laparoscopic surgery has recently been developed to reduce the invasiveness of traditional laparoscopy. This study aimed to assess the safety and feasibility of the single-incision approach for LPEC.
Materials And Methods:
Between June 2009 and March 2010, 117 conventional LPEC and 60 single-incision LPEC (SILPEC) procedures were performed. A laparoscope was placed through a transumbilical incision. A 3-mm grasping forceps was inserted in the lower abdomen in LPEC and through the same transumbilical incision with a different entrance in SILPEC. Using the LPEC needle, the hernia sac was closed extraperitoneally. We compared the short-term outcomes of 177 children operated on using either technique.
Results:
Visualization and tissue manipulation were good in both methods. There were no complications or evidence of early recurrence. Cosmetically, SILPEC proved to be superior to LPEC because the scar resulting from surgical incision is hidden within the umbilicus.
Conclusion:
Single-incision LPEC proved to be as successful an operative procedure as LPEC and produced excellent cosmetic results. Single-incision LPEC for inguinal hernia in children is safe and feasible.
