Single-Site Laparoscopic Percutaneous Extraperitoneal Closure Versus Modified Transumbilical Two-Port Laparoscopic Suturing of the Hernia Sac for the Treatment of Pediatric Inguinal Hernia: Comparison of the Outcomes of Two Different Approaches

Wang, Furan; Zhong, Hongji; Shou, Tiejun; Chen, Yi; Zhao, Jing

doi:10.1089/lap.2018.0405

Cited by 14 publications

(27 citation statements)

References 20 publications

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“…Numerous novel techniques have emerged in laparoscopic surgery for treating pediatric inguinal hernia, which are developed to increase in vitro knotting and reduce puncture [21,22]. The results of our clinical cases suggest that transumbilical single-port laparoscopic water-injection hernia crochet needle inguinal herniorrhaphy is a safe and feasible scar-concealing procedure (Photo 1 D).…”

Section: Discussionmentioning

confidence: 80%

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

Zhou

Chen

Jiang

2019

Videosurgery and Other Miniinvasive Techniques

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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.

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Section: Discussionmentioning

confidence: 80%

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

Zhou

Chen

Jiang

2019

Videosurgery and Other Miniinvasive Techniques

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“…PIRS involves the percutaneous closure of the internal inguinal ring using a spinal needle under the control of a laparoscope [1,2]. If compared to conventional three port laparoscopic pediatric hernia repair, this surgical technique is technically easier with a shorter learning curve, since there is no intracorporeal suturing [1][2][3][4]. Several benefits have been reported including shorter operative time, better cosmetics, no need for tracheal intubation, lower recurrence rates and less possibility of complications [3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

“…If compared to conventional three port laparoscopic pediatric hernia repair, this surgical technique is technically easier with a shorter learning curve, since there is no intracorporeal suturing [1][2][3][4]. Several benefits have been reported including shorter operative time, better cosmetics, no need for tracheal intubation, lower recurrence rates and less possibility of complications [3][4][5][6][7]. A significantly lower level of pain and inflammatory stress response has been reported using the PIRS technique [4,8].…”

Section: Introductionmentioning

confidence: 99%

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Learning Curve for Laparoscopic Repair of Pediatric Inguinal Hernia Using Percutaneous Internal Ring Suturing

et al. 2021

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Background: Percutaneous internal ring suturing (PIRS) is a simple and popular technique for the treatment of inguinal hernia in children. The aim of this study was to analyze the learning curves during implementation of PIRS in our department. Methods: A total of 318 pediatric patients underwent hernia repair using the PIRS technique by three pediatric surgeons with different levels of experience in laparoscopic surgery. These patients were enrolled in a prospective cohort study during the period October 2015–January 2021. Surgical times, intraoperative and postoperative complications, in addition to outcomes of treatment were compared among the pediatric surgeons. Results: Regarding operative time a significant difference among the surgeons was found. Operative time significantly decreased after 25–30 procedures per surgeon. The surgeon with advanced experience in laparoscopic surgery had significantly less operative times for both unilateral (12 (interquartile range, IQR 10.5, 16.5) min vs. 21 (IQR 16.5, 28) min and 25 (IQR 21.5, 30) min; p = 0.002) and bilateral (19 (IQR 14, 21) min vs. 28 (IQR 25, 33) min and 31 (IQR 24, 36) min; p = 0.0001) hernia repair, compared to the other two surgeons. Perioperative complications, conversion, and ipsilateral recurrence rates were higher at the beginning, reaching the benchmarks when each surgeon performed at least 30 PIRS procedures. The most experienced surgeon had the lowest number of complications (1.4%) and needed a fewer number of cases to reach the plateau. The other two surgeons with less experience in laparoscopic surgery had higher rates of complications (4.4% and 5.4%) and needed a higher number of cases to reach the plateau (p = 0.190). Conclusions: A PIRS learning curve for perioperative and postoperative complications, recurrences, and conversion rates reached the plateau after each surgeon had performed at least 30 cases. After that number of cases PIRS is a safe and effective approach for pediatric hernia repair. A surgeon with an advanced level of experience in pediatric laparoscopic surgery adopted the technique more easily and had a significantly faster learning curve.

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“…And double-hand manipulation was beneficial for depth perception and orientation perception, which were the cornerstones for laparoscopic surgery [ 13 , 14 ]. Umbilical one site two-port laparoscopic method achieved the same cosmetic effect with that of the single-port laparoscopic one [ 15 , 16 ]. Obviously, how the two-port instruments manipulating simultaneously in the limited umbilical area was the key point for the technique performance.…”

Section: Introductionmentioning

confidence: 99%

Umbilical two-port laparoscopic percutaneous extraperitoneal closure for patent processus vaginalis in boys: incision-hiding and solo-like surgery

Xiao

Shen

2021

BMC Surg

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Background Transumbilical two-port laparoscopic percutaneous extraperitoneal closure for the treatment of processus vaginalis patency in boys has been practising recent years. The applicable instruments and skills are still evolving. In this study, we used a self-made needle assisted by a disposable dissecting forceps to practise this minimal invasive method for patent processus vaginalis in boys. Its safety and effectiveness were studied. The methods for depth and orientation perceptions were analyzed. Methods From January 2020 to November 2020, boys characteristic of symtomatic patency of processus vaginalis were performed open surgery consecutively. From December 2020, the authors begun to propose transumbilical two-port laparoscopic percutaneous extraperitoneal closure for this kind of boy patients. The open group included fifteen boys and the laparoscopic group included ten ones. The data of the patients age, constituent ratios of unilateral and bilateral patency, operating time, postoperative stay in hospital, follow-up time, conversion, postoperative complications were assessed. Throughout the laparoscopic process, the parallel and synchronous movements of lens pole and dissecting forceps were maintained. Vas deferens protrude was imagined as one of the point to form the triangular manipulation plane. Results There were no statistically significant difference between the laparoscopic group and the open group for the following items: age, operating time, the constituent ratios of unilateral or bilateral patency of processus vaginalis (P > 0.05). Postoperative stay in hospital and follow-up time of the laparoscopic group was significantly shorter than that of the open group (P = 0.0000). No laparoscopic case was converted to open surgery. After 10 cases of laparoscopic practice, orientation perception was established. There were no postoperative complications for all the patients. Conclusion Our preliminary experience suggested that umbilical two-port laparoscopic percutaneous extraperitoneal closure is safe and convenient for patent processus vaginalis treatment in boys. It has the advantage of incision-hiding and can be manipulated like a solo-like surgery.

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Single-Site Laparoscopic Percutaneous Extraperitoneal Closure Versus Modified Transumbilical Two-Port Laparoscopic Suturing of the Hernia Sac for the Treatment of Pediatric Inguinal Hernia: Comparison of the Outcomes of Two Different Approaches

Abstract: Both SLPEC and M-TTLS were the safe and effective methods for PIH. The complications were comparable for M-TTLS and SLPEC, but operation time was significantly longer in M-TTLS than in SLPEC.

Cited by 14 publications

References 20 publications

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

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

Learning Curve for Laparoscopic Repair of Pediatric Inguinal Hernia Using Percutaneous Internal Ring Suturing

Umbilical two-port laparoscopic percutaneous extraperitoneal closure for patent processus vaginalis in boys: incision-hiding and solo-like surgery

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