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Single-port laparoscopic percutaneous extraperitoneal closure of inguinal hernia using "two-hooked" core needle
H Yonggang1, Q Changfu2, W Ping1
1Department of Hernia and Abdominal Wall Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Insights
Single-port laparoscopic percutaneous extraperitoneal closure (SPLPEC) is a safe and effective method for pediatric inguinal hernias. This minimally invasive technique offers short operating times and low recurrence rates.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Hernia Repair
Background:
- Inguinal hernias are common in children.
- Traditional surgical approaches can involve larger incisions and longer recovery times.
- Minimally invasive techniques aim to reduce surgical trauma and improve cosmetic outcomes.
Purpose of the Study:
- To evaluate the surgical outcomes of single-port laparoscopic percutaneous extraperitoneal closure (SPLPEC) for pediatric inguinal hernias.
- To assess the feasibility and reliability of using a "two-hooked" core needle apparatus for this procedure.
- To analyze complication and recurrence rates associated with SPLPEC.
Main Methods:
- A cohort of 518 children under 12 years old with inguinal hernias underwent SPLPEC using a "two-hooked" core needle apparatus and non-absorbable suture.
- The procedure involved a small trans-umbilical incision for port insertion and extracorporeal knot tying.
- Data on operative time, complications, and follow-up outcomes were collected.
Main Results:
- The mean operative time was 13.2 minutes for unilateral and 16.9 minutes for bilateral repairs.
- All patients recovered fully, with no surgical site infections, testicular atrophy, or iatrogenic ascent of the testis.
- Low recurrence (0.39%) and postoperative hydrocele (0.19%) rates were observed at a mean follow-up of 18.7 months.
Conclusions:
- SPLPEC using the "two-hooked" core needle apparatus is a feasible and reliable minimally invasive option for pediatric inguinal hernias.
- The technique demonstrates advantages including short operating times, low complication rates, and favorable cosmetic results.
- This approach offers a safe and effective alternative to traditional open surgery for inguinal hernia repair in children.
Objective:
The aim of this study is to evaluate the surgical outcomes of single-port laparoscopic percutaneous extraperitoneal closure of inguinal hernia using "two-hooked" core needle apparatus in children.
Methods:
This study was conducted at Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine between January 2016 and June 2018. Five hundred and eighteen patients under the age of 12 years with inguinal hernias were subjected to single-port laparoscopic percutaneous extraperitoneal closure (SPLPEC) using non-absorbable suture by "two-hooked" core needle apparatus. Description of the technique is as follows: Under general anesthesia, a 0.5-0.8 cm trans-umbilical skin incision was done for insertion of a 0.5 cm port. A "two-hooked" core needle apparatus was used for insertion of a non-absorbable suture around internal ring. The suture knot was tied extracorporeally.
Results:
Among 518 child patients with inguinal hernias, there were 406 males and 112 females with a mean age of 4.6 ± 3.5 years. One hundred and six cases were subjected to bilateral surgery including 91 cases of contralateral patent processus vaginalis (PPV). Three cases converted to open surgery and additional 0.5 cm port was done in five cases. The mean operative time was 13.2 ± 3.5 min for unilateral hernia repair and 16.9 ± 4.6 min for bilateral cases. All patients achieved full recovery without complications such as surgical site infection (SSI), testicular atrophy, or iatrogenic ascent of the testis. At the mean follow-up time of 18.72 ± 5.27 months, two cases had recurrences (0.39%) and one case had postoperative hydrocele (0.19%).
Conclusion:
SPLPEC of inguinal hernia using "two-hooked" core needle apparatus in children is a feasible and reliable minimal invasive procedure. It has the advantages of short operating time, low complication rate, low recurrence rate and better cosmetic result.
