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A Faster and Simpler Operation Method for Laparoscopic Inguinal Hernia Repair in Children
Kun Wang1, Jing Cai2, Ying-Chou Lu1
1Department of Pediatric Surgery and Dongguan Maternal and Child Health Hospital, Dongguan, Guangdong, China.
Insights
A new single-incision laparoscopic technique for pediatric inguinal hernias (IHs) offers a safe and effective repair. This method reduces operative time, recurrence rates, and scarring, making it a promising advancement in IH treatment.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Hernia Repair
Background:
- Inguinal hernias (IHs) are common in infants and children.
- Current treatments include open and laparoscopic surgery, with laparoscopic herniorrhaphy gaining popularity.
- High ligation of the hernia sac is crucial in IH repair.
Purpose of the Study:
- To introduce and evaluate a novel laparoscopic technique for treating pediatric inguinal hernias.
- To assess the clinical effects and advantages of the "hernia sac ligation by single-incision laparoscopic surgery with a double-line band method."
Main Methods:
- Retrospective review of 119 children undergoing initial laparoscopic herniorrhaphy over one year.
- All surgeries performed by a single surgeon using a modified single-incision laparoscopic technique.
- Analysis of intraoperative findings, operative times, and postoperative complications.
Main Results:
- 119 surgeries completed successfully (58 bilateral, 61 unilateral).
- 93.3% operative success rate with the modified technique.
- One case (0.56%) of hernia recurrence requiring open repair; no intraoperative complications or other significant postoperative issues.
Conclusions:
- The modified single-incision laparoscopic technique is a safe and effective method for pediatric inguinal hernia repair.
- This technique offers reduced operative time, lower recurrence rates, and minimal scarring.
- The procedure is potentially less expensive and shows promise for improved patient outcomes.
Abstract:
Inguinal hernias (IHs) are common in infants and children. The key step in inguinal hernia repair is high ligation of the hernia sac. The current main treatment methods for IHs are open and laparoscopic surgery. Over the past two decades, laparoscopic herniorrhaphy has increased in popularity. Herein, we introduced a new method to laparoscopically treat IHs. The goal of this study was to investigate the clinical effects and advantages of this new operation technique for IHs, which is called the "hernia sac ligation by single-incision laparoscopic surgery with a double-line band method." We retrospectively reviewed the records of all children who underwent initial laparoscopic herniorrhaphy at our center over a 1-year period. A single surgeon performed all surgeries using the modified single-incision laparoscopic technique. Intraoperative findings and complications, operative times, and postoperative complications were reviewed for all children. All 119 surgeries were successfully completed (58 bilateral and 61 unilateral). In total, 54 out of 58 children had contralateral openings discovered at time of surgery and underwent unplanned bilateral laparoscopic hernia repair. This clinical study included 99 boys patients and 20 girls patients (boy-to-girl ratio was 4.95:1). The age range at the time of surgery was 0.5 to 10 years, and the average age was 2.63 years. No patient had any intraoperative complication. Postoperative complications occurred in 1 boy (0.56%) who had a hernia recurrence that required open repair. The addition of auxiliary operating forceps was required for 8 boys (6.72%). No child had scrotum edema, wound infection, stitch granuloma, or iatrogenic cryptorchidism. Overall, a 93.3% operative success rate was noted with the modified technique. The modified technique is a safe and effective operation method, which can significantly shorten the operation time, reduce recurrence rates, and result in minimal scarring. Additionally, the procedure is expected to be less expensive.
