The Safety and Efficacy of Laparoscopic Percutaneous Extraperitoneal Closure for Inguinal Hernia in Neonates and Infants Younger Than 1 Year of Age in Comparison to Older Patients

Yoshimaru, Koichiro; Kinoshita, Yoshiaki; Shono, Toshiyuki

doi:10.1089/lap.2015.0364

Cited by 10 publications

(3 citation statements)

References 26 publications

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“…Open repair (OR) has been the gold standard treatment for indirect inguinal hernia in children for a long time. Recently, there have been several reports regarding the safety and efficacy of laparoscopic percutaneous extraperitoneal closure (LPEC), which is a laparoscopic extraperitoneal herniorrhaphy developed by Takehara et al in 1996 . However, to our knowledge, there have been no reports of LPEC limited to infants younger than 6 months.…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of laparoscopic percutaneous extraperitoneal closure for inguinal hernia in infants younger than 6 months: A comparison with conventional open repair

Zenitani

Saka

Sasaki

et al. 2018

Asian J Endoscop Surgery

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Introduction This study aimed to compare the safety and efficacy of laparoscopic percutaneous extraperitoneal closure (LPEC) and conventional open repair (OR) for inguinal hernia in infants younger than 6 months. Methods The medical records of 202 patients who had undergone LPEC or OR at an age younger than 6 months between 2010 and 2016 were reviewed. Patient characteristics and surgical outcomes were compared between LPEC and OR. Results In total, there were 120 LPEC (76 males, 44 females) and 83 OR (76 males, 7 females) cases. There were no differences in median age, median bodyweight, and presence of incarceration between the two groups (LPEC group: 3 months (range, 0–5 months), 5.7 kg (range, 2.3–9.6 kg), and 13.3%; OR group: 3 months (range, 1–5 months), 5.5 kg (range, 2.1–9.0 kg), and 12.0%). LPEC was completed in all cases without any intraoperative complications or open conversions. In the LPEC group, 60.0% of unilateral hernia patients had a contralateral patent processus vaginalis and underwent prophylactic closure. The incidence of metachronous contralateral hernia was significantly lower in the LPEC group than in the OR group (0% vs 10.0%, P < 0.01). Operative time was significantly shorter during LPEC than during OR (P < 0.01) for male patients. The recurrence rate was lower in the LPEC group (0.83%) than in the OR group (2.4%), but the difference was not significant. Conclusion The present data indicate that LPEC is comparable to OR in terms of safety and efficacy in infants younger than 6 months. Moreover, among the LPEC group, there were fewer incidences of metachronous contralateral hernia, and the procedure had a shorter operative time.

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Section: Introductionmentioning

confidence: 99%

Safety and efficacy of laparoscopic percutaneous extraperitoneal closure for inguinal hernia in infants younger than 6 months: A comparison with conventional open repair

Zenitani

Saka

Sasaki

et al. 2018

Asian J Endoscop Surgery

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“…LPEC was performed as described previously [5] , [6] . The procedure was performed under general anesthesia.…”

Section: Case Reportmentioning

confidence: 99%

Laparoscopic treatment of an abdominoscrotal hydrocele: A case report

Hosoda

Ishioka

Hijikata

2022

International Journal of Surgery Case Reports

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Introduction Abdominoscrotal hydrocele (ASH), a composite of scrotal and abdominal hydroceles connected through the inguinal canal, is rare and no consensus regarding its mechanisms and surgical treatments has been reached to date. Presentation of the case We report a case of an 11-month-old boy with a large ASH. Ultrasonography and magnetic resonance imaging (MRI) revealed a huge hydrocele (maximum length: 8 cm). The patient underwent laparoscopic percutaneous extraperitoneal closure (LPEC) and the orifice of the processus vaginalis (PV) was completely closed. The postoperative course was uneventful. Follow-up ultrasonography and MRI in the first postoperative year showed no recurrence of ASH. Discussion An ASH with a length >8 cm is considered rare in pediatric patients. There is no consensus regarding its etiology and surgical intervention is selected according to the patient's condition and the characteristics of ASH. We opted to perform early surgical intervention considering the ASH size and the adverse effects on testicular development. LPEC helped identify the condition and location of the ASH and allowed safe and reliable operation of the large intrapelvic hydrocele. In patients with no PV patency, a change in approach from LPEC to an open anterior approach should be considered even if LPEC is feasible. Conclusion This case provides valuable insight into successful LPEC of a large ASH without any complications, highlighting the importance of elucidating the morphological mechanisms and making an accurate diagnosis and the challenges associated with these processes.

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“…In 2013, an investigation clarified that LPEC for inguinal hernia of kids is a basic technique wherein a pursestring stitch composed of non-absorbable material is set extra-peritoneally around the hernial hole through a specific sew up needle. 9 The laparoscopic IHR also aids in better inguinal region imagining in this way, permitting CPPV identification that can be shut at the same time since its existence could cause MCIH (metachronous contralateral inguinal hernia) development. 7 There is a lot of delay in picking the laparoscopic approach as an option for available methods.…”

Section: Introductionmentioning

confidence: 99%

Outcome of Laparoscopic Percutaneous Extra Peritoneal Closure Versus Open Repair for Paediatric Inguinal Hernia. A Randomized Control Trial

Ahmed

Hashim²,

Mehmood³

et al. 2022

J Ayub Med Coll Abbottabad

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Background: Laparoscopic inguinal hernia repair (LIHR) has many benefits like less frequency of metachronous contralateral hernias, minimum complications, comparatively less duration of operation and better cosmetic outcome as compared to the open technique. Objective of the study was to compare the outcome of laparoscopic percutaneous extra-peritoneal closure (LPEC) and open repair for paediatric inguinal hernia in terms of contralateral metachronous hernia, operative time and recurrence. Methods: A randomized controlled trial was conducted at the Department of Paediatric Surgery, Children Hospital Lahore. Non-probability purposive sampling was used, and 296 cases were divided into group-1(managed with conventional open repair) and group-2 (managed with laparoscopic Percutaneous Extra-peritoneal closure). After taking informed consent, data was collected, and cases were studied for operative time, contralateral metachronous hernia and recurrence till 6 months postoperatively. Data analysis was done through SPSS 22.0. Chi-square and independent sample t-test was used for comparison. p-value ≤0.05 was taken as significant. Results: The mean operative time was statistically less in the LPEC group (24.79±3.44 minutes) when compared to the open repair group (28.71±4.54 minutes), p-value <0.001. In the Open repair group, there were 19 (12.8%) cases that had contralateral metachronous hernia, while in the LEPC group, 2 (1.4%) cases had contralateral metachronous hernia p-value <0.001. In the Open repair group, 4(2.7%) cases had a recurrence, while in LPEC group 1 (0.7%) cases had a recurrence, with statistically same recurrence rate, p-value >0.05. Conclusion: The LPEC technique is better than conventional open repair in terms of CMIH, operative time, and recurrence rate.

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The Safety and Efficacy of Laparoscopic Percutaneous Extraperitoneal Closure for Inguinal Hernia in Neonates and Infants Younger Than 1 Year of Age in Comparison to Older Patients

Abstract: LPEC is a safe and effective procedure for the repair of an inguinal hernia, even in neonatal and infant patients who are younger than 1 year of age.

Cited by 10 publications

References 26 publications

Safety and efficacy of laparoscopic percutaneous extraperitoneal closure for inguinal hernia in infants younger than 6 months: A comparison with conventional open repair

Safety and efficacy of laparoscopic percutaneous extraperitoneal closure for inguinal hernia in infants younger than 6 months: A comparison with conventional open repair

Laparoscopic treatment of an abdominoscrotal hydrocele: A case report

Outcome of Laparoscopic Percutaneous Extra Peritoneal Closure Versus Open Repair for Paediatric Inguinal Hernia. A Randomized Control Trial

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