Technical Standardization of Laparoscopic Herniorraphy in Pediatric Patients

Esposito, Ciro; Montinaro, L.; Alicchio, Francesca; Scermino, Silvia; Basile, Angela; Armenise, Tommaso; Settimi, Alessandro

doi:10.1007/s00268-009-0121-4

Cited by 43 publications

(34 citation statements)

References 28 publications

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“…The results of Hiroo Takehara et al also support the idea that the hernia sac does not necessarily have to be transacted or removed during hernia repair and that using nonabsorbable sutures can be sufficient to prevent the development of recurrences [24]. On the other hand, some researchers have speculated that complete circumferential incising of the peritoneum, more or less imitating the open procedure, may lead to a reduction in the recurrence rate due to the scarring involved [18,21].…”

Section: Discussionmentioning

confidence: 64%

“…As the above studies show, manipulation of the cord always carries a risk of vascular damage. The laparoscopic technique, with the magnified view of the surgical field on the screen, avoids injuries to the vas and vessels [21]. Furthermore, a rather loose peritoneum at the opening of the internal ring can easily be pulled over to cover the internal ring during suturing [22].…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic hernioraphy: a better approach for recurrent hernia in boys?

et al. 2012

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Laparoscopic hernioraphy: a better approach for recurrent hernia in boys?

et al. 2012

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“…However, this treatment is still controversial because of the four main aspects: (1) the exploration of the asymptomatic contralateral side, (2) the incidence of complications related to the possible damage of the vas deferens or the spermatic vessels, (3) the complications related to the surgical technique, such as recurrences of hernia or iatrogenic cryptorchidism and (4) the possibility to identify, using inguinal exploration, rare hernias such as direct or femoral [3,8,10]. Several papers report that routine bilateral exploration would disclose a contralateral sac in about 20 to 90% of cases (>89% in the first year of life), but contend that only a small percentage of these sacs (8 to 20%) would evolve into clinical hernias [3,6].…”

Section: Discussionmentioning

confidence: 99%

“…Analyzing the international literature, there are mainly two procedures to adopt: unilateral inguinal repair and laparoscopic repair [9,10]. There is no evidence in the international literature about the better procedure to adopt [3,11,12].…”

Section: Introductionmentioning

confidence: 97%

Unilateral inguinal hernia: laparoscopic or inguinal approach. Decision making strategy: a prospective study

Esposito¹,

Giurin²,

Alicchio³

et al. 2012

Eur J Pediatr

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The management of the contralateral region in a child with a known unilateral inguinal hernia is a debated issue among paediatric surgeons. The available literature indicates that the perspective of the child's parents is seldom. This study was performed to evaluate parents' views on this topic. After the Ethical Committee's approval, 100 consecutive patients under 12 years of age with a unilateral inguinal hernia were studied prospectively from March 2010 to September 2010. After an oral interview, a study form was given to the parents about the nature of an inguinal hernia, the incidence of 20 to 90% of a contralateral patency of the peritoneal-vaginal duct and the possible surgical options (inguinal repair or laparoscopic repair). The parents' decision and surgical results were analyzed. Eighty-nine parents chose laparoscopic approach, and 11 parents preferred inguinal exploration. Regarding their motives, all 89 parents requesting laparoscopic approach indicated that the convenience and risk to have a second anaesthesia was the primary reason of their decision. The 11 parents who preferred inguinal approach indicated that the fear of a new surgical technology was their primary reason. Conclusion There is no consensus about the management of paediatric patients with a unilateral inguinal hernia. We believe that a correct decision-making strategy for parents' choice is to propose them the both procedures. Our study shows that parents prefer laparoscopic inspection and repair in the vast majority of cases.

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“…The external inguinal ring is reconstructed. Although the traditional open inguinal approach is effective for hernia repair in the pediatric population [19][20][21], it carries numerous risks, including immediate and long-term postoperative complications [22][23][24]. Postoperative pain, surgical trauma, local swelling usually last 3-5 days for children.…”

Section: Modified Open Pediatric Inguinal Hernia Repairmentioning

confidence: 99%

Individualized Treatment of Inguinal Hernia in Children

Chen¹,

Chu²,

Shen³

et al. 2017

Hernia

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The incidence of inguinal hernias in various age groups of children ranges from 0.8 to 4.4%. Pediatric indirect inguinal hernia is congenital, originating in the patent processus vaginalis. The inguinal hernia repair is one of the most common pediatric operations. The traditional high hernia sac ligation is the primary treatment for younger patients from 1 to 13 years of age and can correct the condition. The authors performed the high ligation of the hernia sac by the laparoscopic approach for the patients under 13 years old and achieved good therapeutic results in the last 10 years. However, through our clinical study, the authors found that the simple high ligation of hernia sac is inadequate for patients from 13 to 18 years of age, who had a longer medical history, larger diameter of the internal inguinal ring, and more serious defects of the transverse fascia. Pediatric inguinal hernias are prone to postoperative recurrence if the patients were only treated with the high ligation of hernia sac. To repair the transverse fascia and strengthen the posterior wall of the inguinal canal, Lichtenstein hernioplasty with a biological patch was performed for the patients from 13 to 18 years in the authors' department. The aims of this chapter are to narrate the individualized treatment of inguinal hernia in children and try to provide relatively reasonable operative methods.

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Technical Standardization of Laparoscopic Herniorraphy in Pediatric Patients

Abstract: We believe that laparoscopic repair of inguinal hernia in expert hands is a safe and effective procedure. It makes it possible to repair all forms of inguinal hernia simultaneously, together with contralateral patencies, which has cemented its role as an alternative to conventional repair.

Cited by 43 publications

References 28 publications

Laparoscopic hernioraphy: a better approach for recurrent hernia in boys?

Laparoscopic hernioraphy: a better approach for recurrent hernia in boys?

Unilateral inguinal hernia: laparoscopic or inguinal approach. Decision making strategy: a prospective study

Individualized Treatment of Inguinal Hernia in Children

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