A 9-year experience study of single-port micro-laparoscopic repair of pediatric inguinal hernia using a simple needle

Abstract Purpose As laparoscopic techniques and equipments improve, laparoscopic inguinal hernia repair has been gaining popularity. The objective of the study was to summarize 9 years of experience using a single-port micro-laparoscopic approach to repair pediatric inguinal hernias with a simple hernia needle. Methods 1880 children with inguinal hernias were enrolled using micro-laparoscopic surgery between June 2009 and 2018. All patients underwent high ligation surgery using a single-port micro-laparoscopic technique. The clinical data were retrospectively analyzed. Results All micro-laparoscopic surgeries were successfully performed in the 1880 patients, who ranged in age from 2 months to 14 years (3.66 ± 2.96 years) including 1622 males and 258 females. Among them, 1299 cases were unilateral hernias and 581 cases were bilateral hernias. The average operating time was 12.5 ± 3.5 min for a unilateral hernia and 20.5 ± 4.5 min for bilateral hernias. All patients were discharged 1–2 days after surgery, and the average length of their hospital stay was 2–4 days. Complications of knot reaction and pneumoscrotum occurred in 5 cases (0.27%) and 54 cases (2.87%), respectively, but these cases were properly managed, with no major impact on the operational outcomes. All patients were followed up for 3–65 months; there were 13 recurrent cases (0.69%). Conclusions Single-port micro-laparoscopic herniorrhaphy in children using a simple hernia needle is a reliable and minimally invasive procedure.

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If laparoscopic technique can be used for treatment of acutely incarcerated/strangulated inguinal hernia?

World Journal of Emergency Surgery ◽

10.1186/s13017-021-00348-1 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Jing Liu ◽

Yingmo Shen ◽

Yusheng Nie ◽

Xuefei Zhao ◽

Fan Wang ◽

...

Keyword(s):

Inguinal Hernia ◽

Postoperative Complications ◽

Open Surgery ◽

Operating Time ◽

Laparoscopic Technique ◽

Laparoscopic Treatment ◽

Tapp Repair ◽

Inguinal Hernias ◽

Laparoscopic Techniques

Abstract Purpose Laparoscopic treatment for acutely incarcerated/strangulated inguinal hernias is uncommon and controversial. In the present study, we assessed the safety and feasibility of transabdominal preperitoneal (TAPP) repair for the treatment of acutely incarcerated/strangulated inguinal hernias. Methods Patients with acutely incarcerated/strangulated inguinal hernias who underwent TAPP repair at the Department of Hernia and Abdominal Wall Surgery (Beijing Chaoyang Hospital) from January 2017 to December 2019 were retrospectively reviewed. Patients’ characteristics, operation details, and postoperative complications were retrospectively analyzed. Results In total, 94 patients with acutely incarcerated/strangulated inguinal hernias underwent TAPP repair. The patients comprised 85 men and 9 women (mean age, 54.3 ± 13.6 years; mean operating time, 61.6 ± 17.7 min; mean hospital stay, 3.9 ± 2.2 days). No patients were converted to open surgery. Hernia reduction was successfully performed in all patients. The morbidity of complications was 20.2% (19/94). Two bowel resections were performed endoscopically. Nine (9.6%) patients avoided unnecessary bowel resections during laparoscopic procedures. All patients recovered well without severe complications. No recurrence or infection was recorded during a mean follow-up period of 26.8 ± 9.8 months. Conclusions TAPP appears to be safe and feasible for treatment of patients with acutely incarcerated/strangulated inguinal hernias. However, it requires performed by experienced surgeons in laparoscopic techniques.

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Development and current status of treatment for pediatric indirect inguinal hernia

Medical Research ◽

10.6913/mrhk.202006_2(2).0001 ◽

2020 ◽

pp. 1-8

Author(s):

Zhifeng Mo ◽

Yuanfei Tan ◽

Hanzhong He ◽

Zhuorong Zhang ◽

Wenbin Yang

Keyword(s):

Inguinal Hernia ◽

Pediatric Surgery ◽

Current Status ◽

High Ligation ◽

Laparoscopic Technique ◽

Common Disease ◽

Indirect Inguinal Hernia ◽

Hernia Sac ◽

Inguinal Hernias ◽

Hernia Inguinal

To investigate the development and current status of the treatment of pediatric indirect inguinal hernia. Inguinal hernias include indirect hernias and direct inguinal hernias, but there are almost indirect inguinal hernias in children . Pediatric indirect inguinal hernia that the most common disease in pediatric surgery is almost caused by patent processus vaginali which incidence ranges from 0.8% to 4.4%.The treatment of pediatric indirect inguinal hernia reflects the process of pediatric surgery development, which from conservative non-surgical treatment to high ligation of the longitudinal incision hernia sac. In recent years, with the continuous improvement of medical level in China, laparoscopic technique has been applied in hospitals all over China, and laparoscopic high ligation of indirect inguinal hernia sac has become the standard for the treatment of pediatric indirect inguinal hernia.

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Postoperative condition of patients as a result of treatment of inguinal hernias by laparoscopic and open methods

Paediatric Surgery Ukraine ◽

10.15574/ps.2021.72.30 ◽

2021 ◽

pp. 30-35

Author(s):

V.V. Skyba ◽

◽

A.V. Ivanko ◽

N.V. Voytyuk ◽

V.V. Lysytsia ◽

...

Keyword(s):

Inguinal Hernia ◽

Surgical Treatment ◽

Open Access ◽

Hospital Stay ◽

Laparoscopic Approach ◽

Length Of Hospital Stay ◽

Lower Percentage ◽

Hernia Surgery ◽

Inguinal Hernias ◽

Inguinal Hernia Surgery

Purpose – to analyze condition of patients after surgical treatment of inguinal hernias by laparoscopic and open methods. Materials and methods. A retrospective review of medical histories and outpatient charts of all patients who underwent inguinal hernia surgery at the Kyiv City Clinical Hospital No. 1 from January 2018 to July 2020 was conducted. Results. During the above period of time in our hospital open hernioplasty was performed in 86 patients, laparoscopic hernioplasty – 138 patients. With open hernioplasty, the average duration of surgical treatment was 40±12 minutes. The laparoscopic technique was 35±12 minutes. The length of hospital stay was significantly longer in the group of patients with the open method (48±12 hours) than in the group of laparoscopic plastic surgery (12±3 hours). From the group of patients who underwent open hernioplasty, 62 patients complained of long-term pain syndrome, from the group of laparoscopy – 12 patients. The cosmetic appearance was dissatisfied with 34 patients in the open access group and only 2 patients in the laparoscopic plastic group. Postoperative complications were observed in 34 patients who underwent surgical treatment through open access, and in 15 patients – by laparoscopy. Conclusions. The laparoscopic approach of inguinal hernia surgery is superior to open access, as it reduces the length of hospital stay, postoperative recovery, improves the aesthetic effect of the operation, reduces the frequency of infection of incisions. According to the results of the study, this technique gives a better result in the early postoperative period, a lower percentage of chronic pain and a higher degree of patient satisfaction compared to open access with the same low recurrence rate. Therefore, in our opinion, laparoscopic access to hernioplasty is the optimal method of treatment and can be recommended as a method of choosing inguinal hernia surgery. Postoperative assessment of the quality of life of patients after treatment of inguinal hernia by laparoscopic and open methods. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: inguinal hernia, laparoscopy, open access surgery, analysis of methods, operation.

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Laparoscopic total extraperitoneal approach for repair of a giant inguinal hernia

International Surgery Journal ◽

10.18203/2349-2902.isj20193663 ◽

2019 ◽

Vol 6 (9) ◽

pp. 3375

Author(s):

Paritosh Gupta ◽

Amanpriya Khanna ◽

Chinmay Arora ◽

Dhruv N. Kundra

Keyword(s):

Inguinal Hernia ◽

Surgical Repair ◽

Upright Position ◽

Extraperitoneal Approach ◽

Inguinal Hernias ◽

Total Extraperitoneal ◽

Laparoscopic Techniques

Giant inguinal hernias are typically described as those which reach patient’s mid-thigh level in upright position. These present a challenge to the surgeon as surgical repair is technically challenging. Although conventionally open repairs have been done for giant inguinal hernias more recently laparoscopic techniques are being adopted. Total extra peritoneal (TEP) and trans abdominal pre peritoneal (TAPP) are two common laparoscopic approaches used. Here we present a case of a 64-year-old patient with a long standing giant inguinal hernia. Hernia was repaired with a TEP approach and patient’s recovery was satisfactory.

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Laparoscopic cauterization of hernia sac in girls; the Burnia technique

Turkish Association of Pediatric Surgeons ◽

10.5222/jtaps.2020.77598 ◽

2020 ◽

Author(s):

Sabriye Dayı

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Abdominal Cavity ◽

Operation Time ◽

Contralateral Side ◽

Hernia Sac ◽

Inguinal Hernias ◽

Laparoscopic Techniques

INTRODUCTION: Inguinal hernia repair is one of the most common surgical procedures in pediatric surgery. In parallel with the advances in the field of medicine, various laparoscopic techniques have been developed in inguinal hernia repair. The Burnia technique is one of the latest published techniques and it is the cauterization of the inguinal hernia sac laparoscopically without using sutures in girls. The aim of this study is the investigation of the use of Burnia technique in clinical practice, and its postoperative outcomes. Any article concerning the use of this technique in Turkey has not been encountered. METHODS: The demographic features of patients, preoperative, peroperative, postoperative and follow-up results of 41 patients who had been operated with Burnia technique by a single surgeon within 2 years were reviewed retrospectively. Laparoscopically, the camera was first placed at an inclination of 30 degrees to the umbilical region using Hasson technique, and then, a single port was used for cauterization of the hernia sac. The Hernia sac was pulled into the abdominal cavity and cauterized. RESULTS: Burnia technique was applied to 62 inguinal hernia sacs in 41 girls. Their ages ranged from 1.5 to 16 years (median 36 months) with body weights ranging between 3.5 kg-40 kg (median 12 kg). Preoperatively 15 patients had right (37%), 19 patients left (46%), 7 patients bilateral inguinal hernias (17%). During surgery, 14 of the unilateral inguinal hernias were found to have a hernia sac on the contralateral side, and the rate of bilateral hernia increased to 51 percent. In one patient ovary was in the inguinal canal, and after its reduction, we proceeded with the operation Unexpectedly. in one patient, right ovarian torsion was detected which was detorsioned, and hernia surgery was performed in the same session. The duration of the operation was 5-35 min (median 15 min) for unilateral and 8-45 min (median 20 minutes) for bilateral hernias. None of these patients developed peroperative and postoperative complications. Follow-up time was minimum 10 months, and maximum 3 years. Recurrence was not detected. DISCUSSION AND CONCLUSION: Burnia technique seems to be effective and safe. The contralateral side and other intra-abdominal pathologies are explored. The cosmetic appearance is its another advantage. The operation time is very short due to the fact that only the hernia sac is cauterized. Comparison of this technique with other laparoscopic techniques is planned in the future study.

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Features of laparoscopic hernioplasty of paracolostomy hernias in patients with combined abdominal pathology

Reports of Vinnytsia National Medical University ◽

10.31393/reports-vnmedical-2020-24(4)-07 ◽

2020 ◽

Vol 24 (4) ◽

pp. 600-603

Author(s):

K. Yu. Parkhomenko

Keyword(s):

Laparoscopic Cholecystectomy ◽

Average Length ◽

Abdominal Cavity ◽

Surgical Interventions ◽

Surgical Department ◽

Inguinal Hernias ◽

Laparoscopic Hernioplasty ◽

Commercial Enterprise ◽

Laparoscopic Techniques ◽

Ventral Hernias

Annotation. The aim of the study is to study the technological features and results of simultaneous laparoscopic hernioplasty of paracolostomy hernias in the presence of combined abdominal pathology. We analyzed the results of surgical treatment of 11 patients with paracolostomy hernias who were treated in the surgical department of the Municipal non-commercial enterprise of the Kharkov regional council “Regional Clinical Hospital” from 2016 to 2020, of whom – women – 4 (36%), men – 7 (64%), aged from 42 to 69 years old. Clinical, anamnestical and instrumental data for the prolongation of cancer were not identified in all patients. Out of 11 patients, in addition to paracolostomy hernia, 3 (27%) had inguinal hernias, 8 (73%) had postoperative ventral hernias. 3 (27%) patients with hernias also had cholecystolithiasis. All patients underwent laparoscopic hernioalloplasty of paracolostomy hernia. 3 patients underwent simultaneous TAPP for inguinal hernias, and 1 patient underwent laparoscopic cholecystectomy and TAPP. 6 patients with incisional ventral hernias underwent simultaneous IPOM according to the standard method, and 2 – according to the own method. Of the above, 2 patients suffering from cholecystolithiasis, in addition to hernioalloplasty, underwent laparoscopic cholecystectomy. In 4 (36%) patients, viscerolysis was additionally performed due to the presence of an adhesive process in the abdominal cavity. Simultaneous hernioalloplasty TAPP and IPOM, as well as laparoscopic cholecystectomy, had no significant effect on the development of complications and the duration of hospitalization. The average length of inpatient treatment was 9.2 bed-days. The study proves the expediency of widespread simultaneous surgical interventions for hernias of the anterior abdominal wall, as well as the preference for laparoscopic techniques.

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Right hemicolectomy – from laparoscopic facilitated technique to robotic intracorporeal anastomosis

Perspectives in Surgery ◽

10.33699/pis.2020.99.3.110-115 ◽

2020 ◽

Vol 99 (3) ◽

pp. 110-115

Keyword(s):

Minimally Invasive ◽

Operating Time ◽

Laparoscopic Approach ◽

Technical Difficulty ◽

Right Hemicolectomy ◽

Intracorporeal Anastomosis ◽

Right Colectomy ◽

The Other ◽

Laparoscopic Technique ◽

Operative Techniques

Several different operative techniques have been applied in minimally invasive right colectomy. Data reported in literature confirm the advantages of laparoscopic approach, however, there is no sure evidence of which one is the best. The pure laparoscopic technique with intracorporeal anastomosis seems to show some advantages compared to the other laparoscopic and open procedures, although for the price of technical difficulty and a longer operating time.

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A Comparison of Outcomes between Lichtenstein and Laparoscopic Transabdominal Preperitoneal Hernioplasty for Recurrent Inguinal Hernia

The American Surgeon ◽

10.1177/000313481808401134 ◽

2018 ◽

Vol 84 (11) ◽

pp. 1774-1780 ◽

Cited By ~ 1

Author(s):

Bin Yang ◽

Shengning Zhou ◽

Yingru Li ◽

Jianan Tan ◽

Shuang Chen ◽

...

Keyword(s):

Inguinal Hernia ◽

Intraoperative Complications ◽

Incidence Rates ◽

Laparoscopic Technique ◽

Recurrent Inguinal Hernia ◽

Complication Rates ◽

Transabdominal Preperitoneal ◽

Inguinal Hernias ◽

Significant Difference

There remain concerns about the optimal technique for repairing recurrent inguinal hernias because of the high risks of complications and recurrence. The aim of this study was to compare Lichtenstein hernioplasty with the transabdominal preperitoneal (TAPP) laparoscopic technique in the treatment of recurrent inguinal hernias. One hundred twenty-two patients who underwent surgery for recurrent inguinal hernia were prospectively randomized to receive either Lichtenstein (n = 63) or TAPP (n = 59) hernioplasty between January 2010 and December 2014. Baseline characteristics, intraoperative complications, and short- and long-term postoperative factors were evaluated. Preoperative factors were comparable between the two groups. The average follow-up period was 46.2 ± 8.5 months. The two groups had similar intraoperative and short-term postoperative complication rates, whereas the rate of long-term postoperative complications was lower for the TAPP group than the Lichtenstein group (6.8% vs 23.8%, respectively, P = 0.012). The TAPP group had significantly lower visual analogue scale scores, fewer analgesics consumption, and faster recovery than the Lichtenstein group ( P < 0.05). Chronic pain was more prevalent in the Lichtenstein group than the TAPP group (15.9% vs 3.4%, respectively, P = 0.031). The recurrence rate was 4.8 per cent for the Lichtenstein group and 1.7 per cent for the TAPP group, with no significant difference ( P = 0.62). Both the Lichtenstein and TAPP procedures are safe and effective methods for repairing recurrent inguinal hernia with low incidence rates of life-threatening complications and recurrence. The TAPP procedure is superior to the Lichtenstein repair in terms of reduced postoperative pain, shorter sick leave, faster recovery, and better cosmetic results. Careful selection of the surgical procedures and implementation of technical essentials are necessary.

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Comparison of Laparoscope-Assisted Single-Needle Laparoscopic Percutaneous Extraperitoneal Closure versus Open Repair for Pediatric Inguinal Hernia

10.21203/rs.3.rs-1156243/v1 ◽

2021 ◽

Author(s):

Shaofeng Wu ◽

Xiaoyu Xing ◽

Rong He ◽

Haiteng Zhao ◽

Liang Zhong ◽

...

Keyword(s):

Inguinal Hernia ◽

Operative Time ◽

Open Repair ◽

Operating Time ◽

Laparoscopic Approach ◽

Bilateral Hernia ◽

Pediatric Inguinal Hernia ◽

The Past ◽

Attractive Option ◽

Contralateral Inguinal Hernia

Abstract Background: Laparoscopic repairs have gained gradual acceptance in pediatric inguinal hernia over the past decade. However, consensus about the optimal management is still lacking. The aim of this study is to present a modified single-needle laparoscopic approach with the assistance of a laparoscope and to evaluate the surgical outcomes in comparison with traditional open repair method. Materials and Methods: We retrospectively reviewed the medical data of children who underwent laparoscope-assisted single-needle laparoscopic percutaneous extraperitoneal closure (LPEC) and open repair (OR) for inguinal hernia from 2014 to 2019. Data were reviewed and analyzed with respect to the operating time, the incidence of metachronous contralateral inguinal hernia (MCIH), recurrence, and other complications. Results: In our cohort, 961 patients in the OR group and 1098 patients in the LPEC group were analyzed retrospectively. Mean operative time was significantly shorter in the LPEC group (22.3±3.5 min) than in the OR group (27.8±5.9 min) for bilateral hernia repair (p<0.001). Iatrogenic cryptorchidism occurred statistically more frequently in the OR group than in the LPEC group (0.4% vs. 0%, p=0.013). In addition, the incidence of MCIH was 3.7% (33/887) in the OR group and 0.3% (3/1014) in the LPEC group (p<0.01). Conclusion: Based on the current outcomes, laparoscope-assisted single-needle LPEC provides a simple and attractive option for the administration of pediatric patients with inguinal hernia/hydrocele to reduce the MCIH.

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