Laparoscopic-assisted percutaneous herniorrhaphy as an alternative to open surgery technique in farm swines

Abstract

Background Despite numerous experimental studies presenting laparoscopic treatment of inguinal hernia in a pig model so far no described technique has been used in clinical patients of this species. Minimal invasiveness and the simplicity of closure of the inguinal canal using the Percutaneous Internal Ring Suturing (PIRS) technique makes it the world’s first technique for laparoscopic treatment of inguinal hernia in pigs as clinical patients. Aim This study aims to assess the applicability and effectiveness of the laparoscopic PIRS technique in the treatment of inguinal hernia in pigs as clinical patients and to compare the PIRS technique with the open surgery technique, which is currently being used. Methods The study was conducted on 22 non-castrated male pigs with inguinal hernia (clinical patients), divided into two equal groups: PIRS and open surgery (OS). In the PIRS group, the inner inguinal ring was closed with an optical trocar inserted at the umbilicus level and an injection needle with a suture material inserted percutaneously over the inguinal canal. The suture material was threaded through the inner inguinal ring and then tied, leaving the knot under the skin. As a result to this the inguinal canal was closed. In the OS group the procedure was performed with open access above the inguinal canal where, after dissection of the vaginal processus and reducing the contents of the hernia to the abdominal cavity, it was ligated as close to the inguinal canal as possible, and the wound was then closed in layers. Results All operated pigs returned to full fitness immediately after recovery from anesthesia. There was one case of hernia recurrence in the PIRS group. In the OS group all the operated pigs had a temporary swelling of the postoperative wound and the scrotum on the side of the operated inguinal hernia, which was not found in the PIRS group. Conclusions The effectiveness of the PIRS technique is comparable to that of open surgery. Considering the simplicity of the PIRS procedure and its minimal invasiveness, this technique may be used as an alternative to the open technique in the treatment of inguinal hernias in pigs not subjected to surgical castration.

Laparoscopy-assisted percutaneous correction of abdominal wall defects in the umbilical region in a cadaveric model of bovine fetus

“…Percutaneous suturing has been used in humans [ 14 ], canines [ 15 ], and swine [ 13 ]. Percutaneous internal ring suturing is a minimally invasive surgical technique for laparoscopic hernia repair.…”

“…A 16-G catheter was used to make the percutaneous suture with the aid of an injection needle to perform the extracorporeal suture in the VG group [ 14 , 15 ]. This technique is a minimally invasive alternative that is easy to perform [ 13 ]. Laparoscopic techniques to reduce hernias have a faster recovery after the procedures compared with conventional methods [ 7 ].…”

“…The methodology adopted by Monteiro et al [ 9 ] and Prządka et al [ 13 ] was used for the establishment of access portals, creation of a study model with the defect in the abdominal wall, and the execution of video-assisted percutaneous suturing technique. The access ports were established in the right flank near the paralumbar fossa, caudal to the ribs, with the direct introduction of the trocar via a parietal incision.…”

Laparoscopically Assisted Percutaneous Inguinal Ring Closure for Resolution of Inguinal/Scrotal Hernias in Rams: Cadaveric Study and Three Cases Report

“…This procedure allows the resolution of the hernia defect in a quick, simple manner and with low recurrence rates, avoiding the use of specific high-cost consumable materials, and, fundamentally, it can be performed without the use of complex laparoscopic techniques [5][6][7]. Recently, a Polish multidisciplinary group of human medicine pediatricians and veterinary surgeons have also reported the use of this technique in the treatment of inguinal hernia in dogs [8] and pigs [9].…”

Difficulties in Diagnosing Extraperitoneal Ureteroinguinal Hernias: A Review of the Literature and Clinical Experience of a Rare Encounter in Acute Surgical Care Settings

“…Similarly, in such cases where the ureter was identified before damaging it, there can still be no option to avoid the ureterectomy due to the impossibility of manipulating it out of the herniation process. In less complicated cases, definitive treatment can be undertaken and obtained by the surgical reduction of the ureter into the abdominal cavity and herniorrhaphy [ 50 , 51 ].…”