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[Laparoscopic hernioplasty in children: evaluating the learning curve]
Balázs Fadgyas1,2, Gábor István Garai1, Enikő Deák3
11 Heim Pál Országos Gyermekgyógyászati Intézet, Sebészeti és Traumatológiai Osztály Budapest, Üllői út 86., 1089 Magyarország.
Orvosi Hetilap
|February 22, 2023
Summary
Percutaneous internal ring suturing (PIRS) is a safe and learnable laparoscopic procedure for childhood inguinal hernias. It effectively identifies metachronous hernias and serves as an excellent training tool.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Surgical Education
Background:
- Inguinal hernioplasty is the most common childhood surgical intervention.
- Evaluating novel laparoscopic techniques is crucial for pediatric surgical training.
Purpose of the Study:
- To assess the learning curve associated with percutaneous internal ring suturing (PIRS).
- To determine the safety and efficacy of PIRS in pediatric patients.
Main Methods:
- A prospective observational cohort study of 126 pediatric patients undergoing PIRS between 2018-2019.
- Exclusion of urgent cases and simultaneous procedures.
- Analysis of surgical time, metachronous hernia incidence, conversions, and complications.
Main Results:
- Average surgical time was 26.5 minutes, decreasing with expertise.
- Surgical duration varied by sex and laterality (unilateral vs. bilateral).
- 28 metachronous hernias identified; low rates of conversions and complications observed.
Conclusions:
- PIRS is a safe and easily learned laparoscopic procedure for pediatric inguinal hernias.
- It serves as an effective method for recognizing metachronous hernias during basic laparoscopic training.
- While PIRS is valuable, traditional open procedures retain a role in treatment.
