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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 inguinal hernia repair in children via PIRS (percutaneous internal ring suturing)
Insights
Percutaneous internal ring suturing (PIRS) is a safe, miniinvasive technique for pediatric inguinal hernias. This approach offers excellent cosmetic results and allows contralateral revision, reducing recurrence rates.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Hernia Repair
Background:
- Minimally invasive surgery is increasingly adopted in pediatric surgery.
- Percutaneous internal ring suturing (PIRS) offers potential benefits of minimally invasive techniques.
Purpose of the Study:
- To evaluate the safety and efficacy of the PIRS technique for pediatric inguinal hernia repair.
- To assess recurrence rates and cosmetic outcomes of PIRS.
Main Methods:
- Prospective study of 73 pediatric patients undergoing PIRS from January 2018 to January 2020.
- Analysis of operative time, recurrence, and cosmetic results.
Main Results:
- 3.3% recurrence rate observed in 73 patients.
- Excellent cosmetic outcomes reported.
- Contralateral inguinal canal revision was possible during PIRS.
Conclusions:
- PIRS is a safe alternative to open surgery for pediatric inguinal hernias.
- The technique allows for preventative contralateral revision.
- PIRS demonstrates excellent cosmetic results and low recurrence rates.
Introduction:
The miniinvasive approach is a trend in pediatric surgery nowadays. The new surgical technique called percutaneous internal ring suturing (PIRS) is a promising method bringing all the benefits of miniinvasive surgery.
Methods:
Prospective study of patients operated on using the PIRS technique from 01 January 2018 to 01 January 2020 at the Department of Pediatric Surgery, 2nd Faculty of Medicine, Charles University, University Hospital Motol.
Results:
73 patients (25 boys and 48 girls) were operated on using PIRS. The median age was 68 months. 90 % of operations were performed by the same team of surgeons. During the procedure there were found 53 right-sided and 38 left-sided inguinal hernias. In 18 cases the hernia was bilateral, but only in 13 cases was this diagnosis made before the operation. A non-absorbable stitch was used in 57 cases to close the internal ring of the inguinal canal, and a non-absorbable monofilament in 16. The median operating time was 34 minutes. There were 3 recurrences (3.3 %) in our study. Conclusion: In our initial study, the PIRS technique proved to be a safe alternative method to the open inguinal hernia surgery. This method provides the benefit of allowing to revise the contralateral inguinal canal as a prevention of a metachronous inguinal hernia. The cosmetic results were excellent.
