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Updated: Oct 31, 2025
Application of Straight-needle, Three-tailed, Knot-free, Peritoneal Sutures in Laparoscopic Transabdominal Preperitoneal Hernia Repair
Published on: November 12, 2021
Laparoscopic percutaneous extraperitoneal closure with peritoneum reinforcement repair for pediatric inguinal hernia:
Shouxing Duan1, Peijian Zhang1, Xiaobin Lin1
1Department of Pediatric Surgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, China.
Insights
Laparoscopic percutaneous extraperitoneal closure with peritoneum reinforcement (LPECPR) offers a safe and effective surgical repair for pediatric inguinal hernias. This technique demonstrates a significantly low recurrence rate, making it suitable for routine use in children.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Hernia Repair
Background:
- Inguinal hernia is a common condition in children requiring surgical intervention.
- Laparoscopic inguinal hernia repair is an established alternative to open surgery.
- Laparoscopic percutaneous extraperitoneal closure with peritoneum reinforcement (LPECPR) is a specific laparoscopic technique.
Purpose of the Study:
- To evaluate the safety and efficacy of the modified LPECPR technique.
- To present the surgical experience with LPECPR in pediatric patients.
- To assess the recurrence rate of LPECPR for pediatric inguinal hernia repair.
Main Methods:
- Retrospective review of 2,018 pediatric patients who underwent LPECPR from July 2011 to December 2020.
- Modified LPECPR technique involving circuit suturing twice around the internal inguinal ring.
- Analysis of operative time, intraoperative and postoperative complications, and recurrence rates.
Main Results:
- All 2,018 cases were completed laparoscopically without conversion or intraoperative complications.
- Mean operative times were 14 minutes for unilateral and 20 minutes for bilateral repairs.
- A low recurrence rate of 0.15% (3/2,018) was observed with a mean follow-up of 13.4 months, with no other significant postoperative complications.
Conclusions:
- The modified LPECPR technique achieves a low recurrence rate for pediatric inguinal hernia repair.
- Midterm safety and efficacy of LPECPR are confirmed.
- LPECPR is a viable and recommended routine procedure for pediatric inguinal hernias.
Background:
Inguinal hernia is one of the common diseases in infants and children that requires operative treatment. Laparoscopic inguinal hernia repair in children has become an alternative to the open procedure. Laparoscopic percutaneous extraperitoneal closure with peritoneum reinforcement (LPECPR) is a safe and effective approach for pediatric inguinal hernia, and has a lower recurrence. This is a retrospective study to present our experience with children who underwent LPECPR.
Methods:
A total of 2,018 patients with inguinal hernia who underwent LPECPR in our hospital from July, 2011 to December, 2020 were reviewed. The surgical technique is modified on the basis of laparoscopic percutaneous extraperitoneal closure (LPEC) to close extraperitoneally by circuit suturing twice around the internal inguinal ring.
Results:
All cases were completed LPECPR without conversion. There were no intraoperative complications. A total of 2,018 patients' laparoscopic procedures were achieved. The mean operative time was 14 and 20 min for unilateral and bilateral operations, respectively. Follow-up to date is 13.4 months (6-36 months), there were no postoperative complications, such as knot reactions, hydrocele formation, testicular atrophy or pain, except 3 recurrences (3/2,018, 0.15%).
Conclusions:
This modified LPECPR technique can acquire lower recurrence rate for repair pediatric inguinal hernia. The midterm safety and efficacy of LPECPR are proven and it can be a routine procedure.
