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Single-incision pediatric endosurgical epigastric hernia repair
A A Babsail1, J S Abelson, D Liska
1Division of Pediatric Surgery, Weill Cornell Medical College, New York Presbyterian, New York, NY, USA.
Insights
A new single-incision pediatric endosurgical (SIPES) technique offers a virtually scarless repair for epigastric hernias in children. This minimally invasive approach is quick, simple, and achieves excellent cosmetic results with no recurrence.
Area of Science:
- Pediatric surgery
- Minimally invasive surgery
- Hernia repair
Background:
- Epigastric hernias constitute approximately 4% of pediatric abdominal hernias and necessitate surgical intervention.
- Traditional open surgical techniques are commonly employed for epigastric hernia repair in children.
- Recent advancements include laparoscopic approaches using two trocars, but a single-incision technique is now described.
Purpose of the Study:
- To describe a novel single-incision pediatric endosurgical (SIPES) technique for epigastric hernia repair.
- To evaluate the feasibility and outcomes of the SIPES technique in pediatric patients.
- To present a minimally invasive alternative to traditional open and multi-trocar laparoscopic repairs.
Main Methods:
- The SIPES technique was utilized for symptomatic epigastric hernias unsuitable for open repair via an umbilical incision.
- Two trocars (5 mm and 3 mm) were inserted through a single umbilical incision.
- Hernia repair was achieved using a lasso technique with 4-0 polypropylene sutures and a spinal needle.
Main Results:
- Five pediatric female patients (ages 4.4-12.6 years) underwent SIPES repair.
- The mean operative time was 25 ± 6 minutes with no intraoperative complications.
- All patients were discharged on the same day, with no recurrence and excellent cosmetic outcomes at 2-3 week follow-up.
Conclusions:
- The SIPES technique provides a virtually scarless, rapid, and straightforward method for repairing symptomatic pediatric epigastric hernias.
- This approach can be executed using standard laparoscopic instrumentation.
- SIPES represents a promising minimally invasive option for pediatric epigastric hernia repair.
Purpose:
Epigastric hernias represent about 4 % of all abdominal hernias in children and require surgical repair. Traditionally, these hernias are repaired by an open surgical technique. More recently, laparoscopic epigastric hernia repairs have been described using two trocars in the upper abdomen. In this paper, we describe a novel single-incision pediatric endosurgical (SIPES) technique.
Methods:
Patients with symptomatic epigastric hernias that were deemed to be too far superior to be repaired with an open technique through an umbilical incision were selected for SIPES repair. Two trocars (5 and 3 mm) were introduced through a single umbilical incision and the hernia repair was performed using looped 4-0 polypropylene sutures introduced through a 17-gage spinal needle in a lasso technique.
Results:
Five girls (age 4.4-12.6, median 6.4 years) underwent single-incision endosurgical epigastric hernia repair. The mean operative time was 25 ± 6 min, and there were no intraoperative complications. All patients were discharged home from the recovery room on the day of surgery. All patients were followed up 2-3 weeks after the operation, with no recurrence and excellent cosmetic results.
Conclusions:
The described SIPES technique offers a virtually scarless, quick, and simple option for the repair of symptomatic epigastric hernias that can be performed with standard laparoscopic equipment.
