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Updated: Jul 26, 2025
Application of Straight-needle, Three-tailed, Knot-free, Peritoneal Sutures in Laparoscopic Transabdominal Preperitoneal Hernia Repair
Published on: November 12, 2021
Comparison of Laparoscopic Percutaneous Extraperitoneal Internal Ring Closure by Two-Hook Hernia Needle and Open
Huaixiao Zhang1, Yuan Feng1, Jianguo Wang1
1Department of Pediatric Surgery, Xiangtan Central Hospital, Xiangtan, China.
Insights
Laparoscopic inguinal hernia repair in children is safe and effective, offering quicker procedures and fewer complications than open repair. This improved technique also aids in detecting contralateral hernias.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Hernia Repair
Background:
- Pediatric inguinal hernia (PIH) is common and often managed with laparoscopic techniques.
- An improved laparoscopic method, the two-hook hernia needle percutaneous extraperitoneal internal ring closure, was developed.
Purpose of the Study:
- To evaluate the safety and effectiveness of the improved laparoscopic repair (LR) versus open repair (OR).
- To compare operation time, surgical complications, contralateral hernia incidence, and recurrence rates between LR and OR.
Main Methods:
- Retrospective analysis of pediatric patients undergoing LR or OR between June 2019 and June 2021.
- Data collected included clinical traits, procedural details, and follow-up information for 370 patients.
Main Results:
- LR was significantly faster (13.82 min unilateral, 21.00 min bilateral) than OR (32.07 min unilateral, 54.85 min bilateral).
- LR showed a lower recurrence rate (1/234) compared to OR (8/136).
- LR identified 58 contralateral occult hernias intraoperatively and had fewer overall complications.
Conclusions:
- Laparoscopic two-hook hernia needle percutaneous extraperitoneal internal ring closure is a safe and effective PIH repair method.
- LR offers advantages including concealed incisions, reduced complications, and better detection of contralateral patent processus vaginalis.
Abstract:
In children, pediatric inguinal hernia (PIH) is a prevalent condition. PIH is currently more frequently managed by laparoscopic closure of the hernia sac. We improved this minimally invasive technique; that is, laparoscopic two-hook hernia needle percutaneous extraperitoneal internal ring closure. Safety and effectiveness were evaluated by comparing the differences between laparoscopic repair (LR) and open repair (OR) in terms of operation time, surgical complications, contralateral metachronous hernia incidence, and recurrence rate. A retrospective clinical data analysis was performed on pediatric patients who had hernia surgery utilizing the LR or OR method between June 2019 and June 2021. Medical records of all of the children were gathered, and clinical traits, information about the procedure, and follow-up were all analyzed. A total of 370 patients' inguinal hernias were repaired. For 136 patients undergoing OR and 234 patients undergoing LR, all procedures were completed satisfactorily. There were 98 cases of bilateral hernias and 272 cases of unilateral hernias (180 on the right side and 92 on the left). In the LR group, 58 patients who had been initially diagnosed with unilateral hernias developed contralateral occult hernias intraoperatively. Inguinal hernia operations took an average of 13.82 (LR) and 32.07 (OR) minutes for unilateral cases, and 21.00 (LR) and 54.85 (OR) minutes for bilateral cases. For LR and OR, the average follow-up time was 22.41 months and 23.10 months, respectively. The perioperative complications included peritoneal rupture in 3 patients, scrotal edema or hematoma in 5, hydrocele in 3, and groin pain in 6. In the LR group, 1 patient experienced the postoperative recurrence, whereas 8 individuals in the OR group did. Our initial research showed that laparoscopic two-hook hernia needle percutaneous extraperitoneal internal ring closure inguinal hernia repair is a safe and effective procedure. The LR method has the benefits of concealing the incision, a quicker procedure, having a lower risk of complications, and finding contralateral patent processus vaginalis. Therefore, promoting and using this surgical technique in clinical practice are merited. Clinical Trial Registration number: Medical Association of Xiangtan (2022-xtyx-28).
