Single-port laparoscopic herniorrhaphy using a two-hooked cannula device with hydrodissection

Area of Science:

• Pediatric Surgery
• Minimally Invasive Surgery
• Laparoscopic Techniques

Background:

• Laparoscopic percutaneous extraperitoneal closure (LPEC) is a recognized method for hernia repair.
• Modifications to LPEC aim to enhance simplicity and reliability.

Purpose of the Study:

• To describe a modified single-port LPEC technique for pediatric inguinal hernias.
• To evaluate the safety, efficacy, and cosmetic results of this modified approach.

Main Methods:

• A modified single-port LPEC technique was used in 1568 children with 2114 inguinal hernias.
• A two-hooked cannula device with preperitoneal hydrodissection facilitated suture placement.
• Medial umbilical fold flap reinforcement was employed for large hernias (>1.5 cm).

Main Results:

• All 2114 hernia repairs were successfully completed using the modified LPEC technique.
• Mean operating times were 9.8 minutes for unilateral and 13.6 minutes for bilateral repairs.
• Low complication rates were observed, with 2 recurrences and 3 hydroceles during follow-up.

Conclusions:

• One-puncture LPEC with the described modifications is safe and effective for pediatric inguinal hernias.
• The technique provides excellent cosmetic results.
• Preperitoneal hydrodissection and the two-hooked cannula aid in efficient hernia closure.