A systematic review and meta-analysis concerning single-site laparoscopic percutaneous extraperitoneal closure for pediatric inguinal hernia and hydrocele

Abstract

SLPEC was a well-developed procedure for repair of pediatric inguinal hernia/hydrocele. Adoption of assisted forceps, hydrodissection, nonabsorbable suture, and the preventive measures to avoid ligating the unnecessary subcutaneous tissues could significantly reduce the intra- and postoperative complications.

Learning Curves for Laparoscopic Repair of Inguinal Hernia and Communicating Hydrocele in Children

“…After a systematic review and mentorship, the percutaneous internal ring suturing (PIRS) technique ( 11 ) leaving no peritoneal gaps was selected and implemented. It favored our choice, the satisfactory cosmesis and the possibility to identify the patency of the contralateral processus vaginalis ( 17 ); among potential disadvantages, we had some reports mentioning higher rates of complications and recurrence ( 18 , 19 ).…”

Effects of Laparoscopic Hernia Repair by PIRS (Percutaneous Internal Ring Suturing) Technique on Testicular Artery Blood Supply

“…More recent publications report lower recurrence and complications rate. 4,5 Recently, published meta-analysis had shown the rate of recurrence of 0.7% which is very similar to open surgery. 1,4 An incidence of complications in hands of experienced laparoscopic pediatric surgeon is very low.…”

“…4,5 Recently, published meta-analysis had shown the rate of recurrence of 0.7% which is very similar to open surgery. 1,4 An incidence of complications in hands of experienced laparoscopic pediatric surgeon is very low. The most common reported complications are injury of blood vessels, recurrence, hydrocele formation, knot reaction, severe pain, and scrotal swelling.…”

“…First reports of PIRS technique had been associated with higher rates of ipsilateral recurrence and residual hydroceles 3,4 This had been attributed to several factors such as the inexperience of the surgeons, the use of absorbable suture, the use of a single suture or larger defects. More recent publications report lower recurrence and complications rate.…”

“…The most common reported complications are injury of blood vessels, recurrence, hydrocele formation, knot reaction, severe pain, and scrotal swelling. 4 An advantage of the PIRS technique is better visualization of the peritoneal cavity, and thus the ability to detect other abnormalities or repair a contralateral open inguinal ring that would be a potential hidden hernia.…”