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Published on: November 12, 2021
A comparative study on trans-umbilical single-port laparoscopic approach versus conventional repair for incarcerated
Zhang Jun1, Ge Juntao2, Liu Shuli1
1Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing, People's Republic of China.
Insights
Single-port laparoscopic repair (SLR) offers a safe and effective minimally invasive option for pediatric incarcerated inguinal hernias, demonstrating comparable outcomes to conventional methods with improved cosmetic results.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Hernia Repair
Background:
- Incarcerated inguinal hernias in children require prompt surgical intervention.
- Conventional repair (CR) methods include open surgery and two-port laparoscopy.
- Evaluating novel minimally invasive techniques like single-port laparoscopic repair (SLR) is crucial.
Purpose of the Study:
- To compare the efficacy and outcomes of single-port laparoscopic repair (SLR) versus conventional repair (CR) for pediatric incarcerated inguinal hernias.
- To assess operative time, complications, cosmetic results, and recurrence rates.
Main Methods:
- Retrospective review of 126 pediatric patients undergoing incarcerated inguinal hernia repair between March and September 2013.
- Patients were divided into three groups: trans-umbilical SLR (Group A), trans-umbilical two-port laparoscopic repair (TLR) (Group B), and conventional open surgery repair (COR) (Group C).
- Data collected included operative time, bleeding volume, post-operative hydrocele, testicular atrophy, cosmetic outcomes, recurrence, and hospital stay.
Main Results:
- All procedures were completed successfully without conversion.
- Operative times varied: SLR (15-24 min), TLR (13-23 min), and COR (35 min).
- Recurrence rates were 0% across all groups. SLR showed statistically significant improvements in cosmetic results compared to TLR and COR, with significant differences noted in operative time, bleeding, hydrocele formation, and hospital stay between the groups (P < 0.001).
Conclusions:
- Single-port laparoscopic repair (SLR) is a safe, effective, and minimally invasive technique for pediatric incarcerated inguinal hernias.
- SLR offers superior cosmetic outcomes compared to conventional methods.
- This new technology warrants further promotion and adoption in pediatric surgical practice.
Purpose:
The purpose of this study is to determine whether singleport laparoscopic repair (SLR) for incarcerated inguinal hernia in children is superior toconventional repair (CR) approaches.
Method:
Between March 2013 and September 2013, 126 infants and children treatedwere retrospectively reviewed. All the patients were divided into three groups. Group A (48 patients) underwent trans-umbilical SLR, group B (36 patients) was subjected to trans-umbilical conventional two-port laparoscopic repair (TLR) while the conventional open surgery repair (COR) was performed in group C (42 patients). Data regarding the operating time, bleeding volume, post-operative hydrocele formation, testicular atrophy, cosmetic results, recurrence rate, and duration of hospital stay of the patients were collected.
Result:
All the cases were completed successfully without conversion. The mean operative time for group A was 15 ± 3.9 min and 24 ± 7.2 min for unilateral hernia and bilateral hernia respectively, whereas for group B, it was 13 ± 6.7 min and 23 ± 9.2 min. The mean duration of surgery in group C was 35 ± 5.2 min for unilateral hernia. The recurrence rate was 0% in all the three groups. There were statistically significant differences in theoperating time, bleeding volume, post-operative hydrocele formation, cosmetic results and duration hospital stay between the three groups (P < 0.001). No statistically significant differences between SLR and TLR were observed except the more cosmetic result in SLR.
Conclusion:
SLR is safe and effective, minimally invasive, and is a new technology worth promoting.
