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Published on: November 12, 2021
A Modified Approach for Inguinal Hernias in Children: Hybrid Single-Incision Laparoscopic Intraperitoneal Ligation
Shuai Li1, Shao-tao Tang1, Tajammool Hussein Aubdoollah1
11 Department of Pediatric Surgery, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .
Insights
This study introduces a hybrid single-incision laparoscopic (H-SIL) technique for pediatric inguinal hernia repair. The H-SIL approach is safe, efficient, and offers excellent cosmetic results with no recurrence in children.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Laparoscopic Techniques
Background:
- Inguinal hernias are common in children, requiring surgical repair.
- Traditional laparoscopic methods can involve multiple incisions.
- Single-incision laparoscopic surgery aims to reduce scarring and improve cosmesis.
Purpose of the Study:
- To evaluate the clinical outcomes of a novel hybrid single-incision laparoscopic (H-SIL) technique for pediatric inguinal hernia repair.
- To assess the safety, efficiency, and cosmetic results of the H-SIL approach.
Main Methods:
- A retrospective analysis of pediatric inguinal hernia cases treated with the H-SIL technique using intracorporeal jumping purse-string sutures.
- Evaluation of operative time, hospital stay, complications, and recurrence rates.
Main Results:
- 157 procedures were performed in 106 children.
- Mean operative time was 15.8 minutes (single) and 20.3 minutes (bilateral).
- No major complications, recurrences, or visible scars were observed; 93% of patients were mobile on day one.
Conclusions:
- The H-SIL technique is a safe and effective method for pediatric inguinal hernia repair.
- It offers comparable maneuverability to multi-port laparoscopy and excellent cosmetic outcomes.
- This approach represents a viable alternative for minimally invasive pediatric hernia surgery.
Purpose:
To report a laparoscopic approach for pediatric inguinal hernia repair using a hybrid single-incision laparoscopic (H-SIL) technique and its clinical outcomes.
Materials And Methods:
A retrospective study was carried out in inguinal hernia cases treated with the new H-SIL approach using intracorporeal jumping purse-string sutures. The operative time, length of postoperative hospital stay, efficiency of the operation, and complications were analyzed.
Results:
In total, 157 inguinal high ligations were performed in 106 children (89 boys, 17 girls). The median age was 1.5 years (range, 25 days-11.6 years). The mean operative time was 15.8±3.4 minutes for the single-side procedure and 20.3±2.5 minutes for bilateral procedures. The mean postoperative hospital stay was 0.99±0.52 (range, 0.25-3 days). No postoperative bleeding, abdominal wall emphysema, abdominal viscera injury, or scrotal edema was found, and there were no known cases of postoperative testicular atrophy or hypotrophy. Ninety-three percent of the patients became fully mobile on the first postsurgical day. The median follow-up period was 17 months (range, 9-21 months), with no recurrence, no visible scars on the abdominal wall, and no foreign body felt in the inguinal region.
Conclusions:
This H-SIL approach is a safe and efficient method for pediatric inguinal hernia repair. The maneuverability is the same as that in the triport laparoscopic technique, and the cosmetic results are similar to those of single-port laparoscopic surgery.
