Pediatric inguinal hernia treated by single-port laparoscopic water injection hernia crochet needle.

Abstract

Introduction: Inguinal hernia is the most common disease in pediatric surgery and is induced by congenital processus vaginalis patency. Almost all inguinal hernias are inguinal indirect hernias, and herniorrhaphy has accounted for about 15% of all pediatric operations. In the past 20 years, with the development of minimally invasive technology, laparoscopic inguinal herniorrhaphy has been emerging in China and in other countries. Aim: To introduce a new technique for treating inguinal hernia in children, and evaluate the feasibility and surgical efficacy of a transumbilical single-port laparoscopic water-injection hernia crochet needle in treating pediatric inguinal hernia. Material and methods: Clinical data of 136 inguinal hernial children treated using a transumbilical single-port laparoscopic water-injection hernia crochet needle in our hospital from June 2017 to December 2018 were retrospectively analyzed. Results: All procedures were successfully accomplished, and no case was converted to a different procedure; the average operation time was 16 min for one side and 35 min for both sides. Patients were followed for an average of 10 months after surgery. One patient had a line-knot reaction at the inguinal puncture point 3 months after surgery and recovered after conservative treatment, and no recurrent case was observed after surgery. Conclusions: It is feasible to treat pediatric inguinal hernia through a transumbilical single-port laparoscopic water-injection hernia crochet needle, which is associated with safety, less trauma, rapid recovery, no obvious scar, and satisfactory efficacy. Therefore, it is worthy of being promoted and applied in clinical practice.

A comparative study examining laparoscopic and open inguinal hernia repair in children: a retrospective study from a single center in China

“…LHR can detect MCH and contralateral PPV simultaneously, which is a significant advantage of laparoscopic surgery over open surgery [ 11 ]. However, it is still controversial whether the contralateral PPV should be ligated at the same time [ 4 ]. Some scholars believe that only 10% of the contralateral PPV patients will further develop into MCH, and there is no need for treatment [ 12 ].…”

“…Traditional open hernia repair (OHR) has been implemented in the clinic for many years, which has the characteristics of simple operation and strong popularity [ 3 ]. Some scholars believe that it is necessary to open the inguinal canal, which causes postoperative pain, and it is easy to damage spermatic vessels and the vas deferens [ 4 ]. However, laparoscopic hernia repair (LHR) has the advantages of having a concealed scar, being minimally invasive, and having the ability to detect the contralateral PPV.…”

Multifactor study of efficacy and recurrence in laparoscopic surgery for inguinal hernia

“…On the one hand, the magnification effect of laparoscopy can be observed in children with inguinal hernia. The clear visualization of the spermatic cord, vas deferens and other structures reduces the chance of injury; additionally, the incision is small, the scar is aesthetically pleasing, and the recovery after surgery in children is fast[ 14 ]. On the other hand, laparoscopic surgery does not cause loss of tissue in the inguinal region during high hernia sac ligation, and there is no need to separate the spermatic cord.…”

The investigation survey of inguinal hernia operation techniques preferred by pediatric surgeons in Turkey

“…(17) stated that number of cases required to perform laparoscopic inguinal hernia repair safely without supervision was 20 cases. However, the treatment of transumbilical single-port laparoscopic IH (PIRS) has been found to be much easier to learn and apply due to no need for classical three-port laparoscopy maneuvers (18). As a result, learning process and competent practical use of the PIRS method may be faster than other techniques.…”