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Published on: November 12, 2021
Percutaneous Internal Ring Suturing for the Minimal Invasive Treatment of Pediatric Inguinal Hernia: A 5-Year Single
Zenon Pogorelić1,2, Tin Čohadžić2, Miro Jukić1,2
1Department of Pediatric Surgery, University Hospital of Split.
Insights
Percutaneous internal ring suturing (PIRS) is a safe and effective laparoscopic technique for pediatric inguinal hernia repair. This study shows PIRS offers excellent outcomes with minimal complications and recurrence in children.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Laparoscopic Hernia Repair
Background:
- Inguinal hernias are common in children.
- Traditional surgical repair can have drawbacks.
- Minimally invasive techniques offer potential advantages.
Purpose of the Study:
- To evaluate the management and postoperative outcomes of percutaneous internal ring suturing (PIRS) for pediatric inguinal hernia repair.
- To assess the safety and efficacy of PIRS in a pediatric population.
Main Methods:
- Prospective cohort study of children undergoing PIRS for inguinal hernia between February 2015 and February 2020.
- Data collected included patient demographics, hernia characteristics, surgical details, hospital stay, and complications.
- Median follow-up was 46 months.
Main Results:
- 228 PIRS procedures in 188 children were analyzed.
- Median surgical time was 10 minutes for unilateral and 16 minutes for bilateral repairs.
- Low complication rate (1.3% intraoperative vein injury) and no recurrences were observed; 3 cases of hydrocele occurred, with 2 resolving spontaneously.
Conclusions:
- Percutaneous internal ring suturing (PIRS) is a simple, safe, and effective technique for pediatric inguinal hernia repair.
- PIRS demonstrates excellent outcomes, good cosmetic results, and a low incidence of complications and recurrence when performed by experienced surgeons.
Purpose:
Percutaneous internal ring suturing (PIRS) is a minimally invasive surgical technique of laparoscopic hernia repair in children under the control of a laparoscope placed in the umbilicus. The aim of this study was to evaluate the management and postoperative outcomes of PIRS for inguinal hernia repair in children.
Patients And Methods:
All children who underwent PIRS for an inguinal hernia, between February 2015 and February 2020, were included in the prospective cohort study. The following parameters were recorded: age, gender, body mass index, lateralization of hernia, surgical and anesthesia times, level of pneumoperitoneum, additional trocar introduction, length of hospital stay, and intraoperative or postoperative complications and recurrences were recorded.
Results:
A total number of 228 PIRS procedures were performed in 188 children [126 (67%) male individuals and 62 (33%) female individuals] with a median age of 4 [interquartile range (IQR), 2 to 6] years and a median follow-up of 46 (IQR, 38 to 52) months. From the total number of hernia repairs there were 99 (52.7%) right, 49 (26.1%) left, and 40 (21.2%) bilateral hernia repairs. Median surgical time was 10 (IQR, 8 to 12) minutes for unilateral and 16 (IQR, 14 to 20) minutes for a bilateral repair. The median hospital stay was 24 (IQR, 8 to 24) hours. Regarding intraoperative complications, only 3 (1.3%) inferior epigastric veins injuries were recorded, without any consequences. During the follow-up period in 3 male children, hydrocele was recorded; in 2 cases, hydrocele resolved spontaneously and 1 required surgical treatment. No cases of other complications including testicular atrophy or recurrence were recorded.
Conclusion:
In a hands of an experienced pediatric laparoscopic surgeon, PIRS is a simple, safe, and effective technique for inguinal hernia repair in children with excellent outcomes, cosmetic results, and a low incidence of complications and recurrence.
