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Percutaneous hernia repair in children: Safe to introduce
Johan Danielson1, Niklas Pakkasjärvi2,3, Niclas Högberg4,2
1Department of Pediatric Surgery, Akademiska Sjukhuset, Uppsala, S-75185, Sweden.
Insights
Percutaneous internal ring suture offers a safe, effective alternative for inguinal hernia repair, significantly reducing operative and theater time compared to traditional open surgery.
Area of Science:
- Minimally Invasive Surgery
- Surgical Techniques
- Hernia Repair
Background:
- Introduction of percutaneous internal ring suture (PIRS) in 2014 as an alternative to open inguinal hernia repair.
- Evaluation of the initial implementation and outcomes of PIRS at a single institution.
Purpose of the Study:
- To assess the safety and efficacy of the percutaneous internal ring suture procedure.
- To compare operative time, theater time, and postoperative complications between PIRS and open surgery for inguinal hernias.
Main Methods:
- Retrospective comparison of 100 consecutive patients undergoing PIRS versus 100 undergoing open surgery.
- Data collected included patient demographics, clinical history, operative time, theater time, and postoperative complications.
- Follow-up data on hernia recurrence and other complications were analyzed.
Main Results:
- PIRS demonstrated a significantly shorter mean operative time (26.54 min) compared to open surgery (39.94 min).
- Total mean operative theater time was also reduced with PIRS (108.95 min) versus open surgery (118.4 min).
- Recurrence rates were low in both groups, with PIRS having two recurrences and open surgery three.
Conclusions:
- Percutaneous internal ring suture is a safe and effective technique for inguinal hernia treatment.
- PIRS offers significant advantages in reducing operative and theater time compared to open surgery.
- The procedure is a viable alternative for inguinal hernia repair, even as a newly established technique.
Background And Objective:
In 2014 we introduced percutaneous internal ring suture as an alternative to open surgery for the treatment of inguinal hernia. This study aims to evaluate the introduction of the procedure at our institution.
Methods:
In total, 100 consecutive patients operated with percutaneous internal ring suture were compared with 100 consecutive patients operated with open surgery. The patients were operated from August 2014 until November 2017. Patient demographics, clinical history, operative time, time in theater, and postoperative complications were extracted from charts.
Results:
The mean operative time for percutaneous internal ring suture was 26.54 min and for open surgery 39.94 min, P < 0.0001. The total mean operative theater time for percutaneous internal ring suture was 108.95 min and for open surgery 118.4 min, P = 0.0343. During follow-up, two percutaneous internal ring sutures were operated for recurrent hernia. In the open surgery-group, three patients were operated for recurrent hernia, three for secondary testicular retention, and three for metachronous contralateral hernia.
Conclusions:
Even when established as a new technique, the percutaneous internal ring suture procedure is safe and results in shorter operative time and shorter theater time compared to open surgery.
