Modification of the Classical Percutaneous Extraperitoneal Procedure for Pediatric Inguinal Hernia to Reduce Complications: A Multiple-Centered Comparison Study

Abstract

Single-site laparoscopic percutaneous extraperitoneal ligation (SLPEL) for pediatric inguinal hernia gained popularity all over the world. However, complications associated with extraperitoneal knotting were not rare in the classical SLPEL(C-SLPEL) procedure. In order to overcome disadvantages, we herein developed the modified SLPEL (M-SLPEL) procedure, intact circuit ligation of the peritoneum around the internal ring using a homemade hernia needle with a single abdominal wall centesis. To evaluated the effectiveness of the M-SLPEL procedure to decrease adverse events associated with ligation knotting, a comparative study was carried out. A total of 3219 patients from multiple centers were divided into two groups according to the operative procedures: M-SLPEL group and C-SLPEL group. All patients were followed up. Data describing the clinical characteristics, operative time, postoperative hospital stay, and complications was collected and retrospectively analyzed. With equivalent operative time, postoperative hospital stay, there was statistically significant difference between two groups in terms of the overall complications incidence (2.6% in C-SLPEL Vs 0.11% in M-SLPEL, P=0.03), including pain in inguinal area, knot foreign body reaction, palpable knot, recurrence. Together, these findings suggest that the M-SLPEL procedure is an effective and safe approach, with unique advantage in reducing adverse events in the inguinal region.

Application of Quantitative Assessment Strategy-Based Nursing Combined with Empathic Nursing in Patients Undergoing Tension-Free Inguinal Herniorrhaphy

“…Inguinal hernia is a common and frequently occurring disease in clinics, which is easy to recur. Clinically, it is believed that the crucial causes of the disease are mainly the decrease in abdominal wall strength and the increase in intra-abdominal pressure [ 15 ]. At present, the clinical treatment of inguinal hernia is mainly surgery.…”