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Application of Straight-needle, Three-tailed, Knot-free, Peritoneal Sutures in Laparoscopic Transabdominal Preperitoneal Hernia Repair
Published on: November 12, 2021
Laparoscopic Extracorporeal Ligation of the Internal Inguinal Ring by a Spinal Needle: a Simple Method of Hernia
1Gauhati Medical College, B. K. Kakoti Road, 2nd lane, Ulubari, Guwahati, Assam India.
Insights
This study introduces a simple laparoscopic technique for pediatric hernia repair using a spinal needle to close the internal inguinal ring. The method proved safe and effective, offering minimally invasive benefits for children.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
Background:
- Laparoscopic hernia repair is an emerging technique for children.
- Current laparoscopic methods involve intracorporeal or extracorporeal suturing for internal ring closure.
Purpose of the Study:
- To describe and evaluate a novel, simple laparoscopic technique for internal inguinal ring closure in pediatric hernia repair using a spinal needle.
- To assess the safety and efficacy of this technique.
Main Methods:
- A percutaneous technique using a spinal needle to pass a prolene thread around the internal inguinal ring under laparoscopic control.
- Sutures were tied extracorporeally in the subcutaneous plane.
- The technique was applied to 43 hernias in 41 pediatric patients (1.5–12 years old).
Main Results:
- All 43 hernias were successfully repaired with no intraoperative or postoperative complications.
- The study included 15 females and 26 males, with 31 right-sided, 8 left-sided, and 2 bilateral hernias.
- The technique demonstrated advantages of minimally invasive surgery, including reduced pain and improved cosmesis.
Conclusions:
- This spinal needle technique offers a simple, effective, and safe laparoscopic approach for pediatric inguinal hernia repair.
- It requires no special equipment or advanced laparoscopic skills, making it accessible.
- The method provides the benefits of minimally invasive surgery for pediatric patients.
Abstract:
Laparoscopic repair has emerged recently as an alternative technique for hernia repair in children. Various methods of repair have been described. Basic principle is to close the internal inguinal ring either by intracorporeal or by extracorporeal suturing. The objective of this study is to describe and evaluate the outcome of a simple technique of internal ring closure by a spinal needle. A total of 43 hernias in 41 patients were repaired. A prolene thread was passed percutaneously around the internal inguinal ring by threading it though a spinal needle under laparoscopic control. The suture is then tied extracorporeally in the subcutaneous plane. There were 15 female and 26 male patients in the age group of 1½ to 12 years. Right-sided hernia was present in 31 cases and left-sided hernia in eight cases, and two cases had bilateral hernia. All cases were repaired successfully. There was no intraoperative or postoperative complication. This new technique has all the advantages of laparoscopic hernia repair in children (minimally invasive, less pain, less complication, and cosmesis). In addition, the method is simple and it does not need any special equipment or advanced laparoscopic skill.
