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A novel technique for laparoscopic inguinal hernia repair in children: single-port laparoscopic percutaneous
Engin Yilmaz1, Cagatay Evrim Afsarlar, Emrah Senel
1Department of Pediatric Surgery, Dr Sami Ulus Maternity and Children's Hospital, No: 44, Babur caddesi, Altındağ, 06080, Ankara, Turkey, cocukcerrahisi@hotmail.com.
Insights
The modified single-port laparoscopic percutaneous extraperitoneal closure (SPEC-OFF) technique offers a safe and effective method for pediatric inguinal hernia repair. This approach results in excellent cosmetic outcomes with minimal recurrence rates.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Laparoscopic Techniques
Background:
- Inguinal hernias are common in pediatric patients.
- Traditional surgical approaches can lead to complications and visible scarring.
- The single-port percutaneous extraperitoneal closure (SPEC) technique offers a minimally invasive alternative.
Purpose of the Study:
- To describe and evaluate a modified SPEC technique (SPEC-OFF) using optical foreign-body forceps (OFF) for pediatric inguinal hernia repair.
- To assess the safety, efficacy, and cosmetic outcomes of the SPEC-OFF technique.
Main Methods:
- Retrospective review of 79 children (99 repairs) who underwent SPEC-OFF between January 2012 and January 2014.
- The SPEC-OFF technique utilized modified optical foreign-body forceps (OFF) from a rigid bronchoscope.
- Data collected included demographic features, clinical data, operative time, follow-up duration, and post-operative outcomes.
Main Results:
- The mean operative time was 17.6 ± 5.5 minutes, with a mean follow-up of 17.5 ± 7.1 months.
- Six recurrences (6.1%) were observed.
- No cases of wound infection, hydroceles, or testicular atrophy occurred.
- The technique resulted in excellent umbilical and groin cosmesis due to small scars.
Conclusions:
- The SPEC-OFF technique is a simple, safe, and effective method for pediatric laparoscopic inguinal hernia repair.
- It allows for accurate determination of contralateral hernias.
- The technique eliminates the need for additional working forceps and surgeon assistance.
Aim:
The aim of this study was to describe and report the results of our new pediatric inguinal hernia repair technique, in which single-port laparoscopic percutaneous extraperitoneal closure (SPEC) technique was modified by using optical foreign-body forceps (OFF) of the rigid bronchoscope.
Materials And Methods:
Between January 2012 and January 2014, a total of 79 children who were operated using SPEC assisted with OFF (SPEC-OFF) were included in this study. Demographic and clinical features of the children were obtained and reviewed retrospectively.
Results:
Ninety-nine hernia repairs were performed on a total of 79 children (51 boys, 28 girls). All of the patients were operated by SPEC-OFF without the need of introducing extra forceps, with or without an additional trocar. The mean operating time was 17.6 ± 5.5 min. The mean follow-up period was 17.5 ± 7.1 months. There were six recurrences (two boys, four girls). No wound infection, hydroceles or testicular atrophy occurred in any patients during post-surgery follow-up. The technique left a very small scar with excellent cosmesis in the umbilicus and groin area.
Conclusions:
SPEC-OFF is a simple, safe and effective technique for laparoscopic inguinal hernia repair, and for determining contralateral hernia. There is no need to use additional working forceps for the technique and the surgeon can perform the procedure without any assistance for laparoscope.
