Two Ports Laparoscopic Inguinal Hernia Repair in Children

Introduction. Several laparoscopic treatment techniques were designed for improving the outcome over the last decade. The various techniques differ in their approach to the inguinal internal ring, suturing and knotting techniques, number of ports used in the procedures, and mode of dissection of the hernia sac.Patients and Surgical Technique. 90 children were subjected to surgery and they undergone two-port laparoscopic repair of inguinal hernia in children. Technique feasibility in relation to other modalities of repair was the aim of this work. 90 children including 75 males and 15 females underwent surgery. Hernia in 55 cases was right-sided and in 15 left-sided. Two patients had recurrent hernia following open hernia repair. 70 (77.7%) cases were suffering unilateral hernia and 20 (22.2%) patients had bilateral hernia. Out of the 20 cases 5 cases were diagnosed by laparoscope (25%). The patients’ median age was 18 months. The mean operative time for unilateral repairs was 15 to 20 minutes and bilateral was 21 to 30 minutes. There was no conversion. The complications were as follows: one case was recurrent right inguinal hernia and the second was stitch sinus.Discussion. The results confirm the safety and efficacy of two ports laparoscopic hernia repair in congenital inguinal hernia in relation to other modalities of treatment.

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A comparative study between open and laparoscopic repair of inguinal hernia

International Surgery Journal ◽

10.18203/2349-2902.isj20193681 ◽

2019 ◽

Vol 6 (9) ◽

pp. 3353

Author(s):

Mahim Koshariya ◽

Mayank Soni ◽

Prateek Malpani ◽

Bhupendra Parmar ◽

Shikha Shukla

Keyword(s):

Inguinal Hernia ◽

Postoperative Pain ◽

Hernia Repair ◽

Comparative Study ◽

Hospital Stay ◽

Laparoscopic Repair ◽

Operative Time ◽

Laparoscopic Hernia Repair ◽

Repair Group ◽

Open Hernia Repair

Background: Hernias of the abdominal wall constitute an important public health problem. Laparoscopic inguinal hernia repair (TEP) is a minimal access surgical procedure as compared to open hernia repair. The objective of the study was to compare open and laparoscopic hernia repair in terms of safety, complications, morbidity, recurrence, post-op pain and hospital stay.Methods: This was a prospective observational comparative study. Total 50 patients were taken in this study; out of them 25 patients subjected to group A (open repair of inguinal hernia) and 25 patients subjected to group B (laparoscopic repair of inguinal hernia). Postoperatively patients were observed for any complications and followed up one year.Results: Present study shows high incidence of inguinal hernia in males. Mean operative time for open hernia repair group was less than laparoscopic hernia repair group. Time to return to normal work, duration of hospital stay and postoperative pain were less in laparoscopic hernia repair group than open hernia repair group. Out of 25 patients in laparoscopic hernia repair (TEP) 1 patient had recurrence but in open hernia repair group there was no recurrence.Conclusions: Laparoscopic hernia repair is quite safe; it has definite advantages in bilateral and recurrent cases, postoperative pain, early return to normal activities, less postoperative hospital stay and better cosmetic results although it has its own disadvantages in terms of recurrence rate, operative time and cost effectiveness.

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Laparoscopic inguinal hernia repair (total extra-peritoneal): tips and tricks

Journal of Society of Surgeons of Nepal ◽

10.3126/jssn.v18i3.15334 ◽

2016 ◽

Vol 18 (3) ◽

pp. 62

Author(s):

SM Bhattarai ◽

G Simkhada ◽

T Shah ◽

RK Gupta

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Laparoscopic Hernia Repair ◽

Length Of Hospital Stay ◽

Laparoscopic Technique ◽

Tertiary Referral Center ◽

Operative Difficulty ◽

The Mean ◽

Groin Hernias ◽

Open Hernia Repair

Introduction: Inguinal hernia is one of the major problems at B.P. Koirala Institute of Health Sciences (BPKIHS), a tertiary referral center. We perform Laparoscopic hernia repair as a routine procedure for groin hernias. This technique is highly demanding and complex. In our country the development of laparoscopic technique is still in a developing phase.Aims and objective: To present technical tips and trick in LIHR, which we experienced, as lead to preventing intra/post operative complication.Results: We have performed a total of 129 groin hernia repairs in 105 patients with M: F= 26:1 and mean age 41.97±20 (16-85). The mean length of hospital stay was 1.14 ± 0.35 days. Eight patients were converted to TAPP and 1 converted to open hernia repair due to operative difficulty. The complications encountered are pain (20), seroma(8) and epididymitis(2).Conclusion: In our experience LIHR (TEP) is safe method for routine management of groin hernias.

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LAPAROSCOPIC TRANS-ABDOMINAL PRE-PERITONEAL (TAPP) REPAIR FOR TREATMENT INGUINAL HERNIA DISEASE

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2018.4.11 ◽

2018 ◽

Vol 8 (4) ◽

pp. 76-80

Author(s):

Thao Nguyen Minh ◽

Vu Pham Anh ◽

Tri Nguyen Huu ◽

Phu Nguyen Doan Van ◽

Phuc Nguyen Thanh ◽

...

Keyword(s):

Inguinal Hernia ◽

Operative Time ◽

Bilateral Hernia ◽

Repair Method ◽

Tapp Repair ◽

Post Operation ◽

Average Operative Time ◽

The Mean

Background: Inguinal hernia is one of the commonest surgical diseases and there are many different techniques applied. The laparoscopic trans-abdominal pre-peritoneal (TAPP) repair allows a better view of the inguinal anatomy, evaluation of opposite side and resolve combined peritoneal diseases as well. Patient and method: The study included 60 cases with inguinal hernia that have been treated by laparoscopic transabdominal pre-peritoneal (TAPP) repair. Method: Description, prospective follow-up. Result: The mean age was 58±18.2. 96.7% were males. The average operative time was 45.6±15.1 minutes for one side hernia, 73±25.2 minutes for bilateral hernia. 02 cases have been post-operation inguinal seroma complication (3.3%), 02 cases with hydrocele (3.3%), 01 case with abdominal seroma (1.7%). 04 cases (6.7%) opposite inguinal hernia were detected and 05 cases (8.3%) with combined diseases were resolved. Duration of post-operative stay was 3.9±1.1 days. Conclusion: TAPP is a safe and feasible procedure, allows evaluation of opposite side and resolve combined peritoneal diseases.

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Comparative study between laparoscopic trans-abdominal preperitoneal and open mesh hernioplasty in repair of non-complicated inguinal hernia

International Surgery Journal ◽

10.18203/2349-2902.isj20195944 ◽

2019 ◽

Vol 7 (1) ◽

pp. 24

Author(s):

Waleed Yusif El Sherpiny

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Hospital Stay ◽

Laparoscopic Hernia Repair ◽

Laparoscopic Group ◽

Routine Activities ◽

Group A ◽

Group B ◽

Open Hernia Repair ◽

Mesh Hernioplasty

Background: Inguinal mesh hernioplasty is one of the common procedures performed all over the world. It can be done either through open or laparoscopic techniques. The aim of this study was to compare the outcomes of Lichtenstein tension free hernioplasty versus laparoscopic transabdominal pre-peritoneal (TAPP) mesh repair considering, duration of the surgery, hospital stay, and duration to resume normal activity, degree of postoperative pain, wound infection, recurrence and complications.Methods: Adult patients presented to the general surgical OPD, with the diagnosis of inguinal hernia underwent either Lichtenstein repair or laparoscopic repair by TAPP.Results: Patients in Group A (open-repair) had significantly greater level of local pain during rest and during routine activities than those within Group B (laparoscopic group) during the postoperative period assessed on the visual-analogue scale. Mean operative time for open hernia repair was 43.7 minutes and for laparoscopic hernia repair was 59.03 minutes and the difference were statistically significant (p=0.0001). The mean duration of hospital stay for open hernia repair was 2.16 days and that for laparoscopic hernia repair was 1.08 days with a (p=0.00001) which was statistically significant. The time to resume routine activities was much shorter among Group B patients than patients in Group A. Only one recurrence (3.3%) was seen in Group B after 6 months follow up.Conclusions: It is concluded that laparoscopic TAPP repair of inguinal hernia in adults is safe and preferred operation as compared to open inguinal hernia repair.

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Outcomes of an innovative training course in laparoscopic hernia repair

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2017.0094 ◽

2017 ◽

Vol 99 (8) ◽

pp. 614-616 ◽

Cited By ~ 1

Author(s):

D Light ◽

S Bawa ◽

P Gallagher ◽

L Horgan

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Ventral Hernia ◽

Inguinal Hernia Repair ◽

Ventral Hernia Repair ◽

Operative Time ◽

Laparoscopic Inguinal Hernia Repair ◽

Laparoscopic Ventral Hernia Repair ◽

Hernia Surgery ◽

The Mean

Introduction The Ethicon™ laparoscopic inguinal groin hernia training (LIGHT) course is an educational course based on three days of teaching on laparoscopic hernia surgery. The first day involves didactic lectures with tutorials. The second day involves practical cadaveric procedures in laparoscopic hernia surgery. The third day involves direct supervision by a consultant surgeon during laparoscopic hernia surgery on a real patient. We reviewed our outcomes for procedures performed on real patients on the final day of the course for early complications and outcomes. Methods A retrospective study was undertaken of patients who had laparoscopic hernia surgery as part of the LIGHT course from 2013 to 2015. A matched control cohort of patients who had elective laparoscopic hernia surgery over the study period was identified. These patients had their surgery performed by the same consultant general surgeons involved in delivering the course. All patients were followed up at 6 weeks postoperatively. Results A total of 60 patients had a laparoscopic inguinal hernia repair and 23 patients had a laparoscopic ventral hernia repair during the course. The mean operative time for laparoscopic inguinal hernia repair was 48 minutes for trainees (range 22–90 minutes) and 35 minutes for consultant surgeons (range 18–80 minutes). There were no intraoperative injuries or returns to theatre in either group. All the patients operated on during the course were successfully performed as daycase procedures. The mean operative time for laparoscopic ventral hernia repair was 64 minutes for trainees (range 40–120 minutes) and 51 minutes for consultant surgeons (range 30–130 minutes). Conclusions The outcomes of patients operated on during the LIGHT course are comparable to procedures performed by a consultant. Supervised operating by trainees is a safe and effective educational model in hernia surgery.

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Characteristics and Treatments for Pediatric Ordinary and Incarcerated Inguinal Hernia Based on Gender: 12-Year Experiences from a Single Center

10.21203/rs.3.rs-35681/v3 ◽

2020 ◽

Author(s):

Kai Wang ◽

Sarah Siyin Tan ◽

Yue Xiao ◽

Zengmeng Wang ◽

Chunhui Peng ◽

...

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Large Scale ◽

Operative Time ◽

Hospital Costs ◽

Recurrent Hernia ◽

Incarcerated Hernia ◽

Incarcerated Inguinal Hernia ◽

Large Scale Analysis

Abstract Background: Congenital primary inguinal hernia is a common condition among children. Although much literature regarding inguinal hernia is available, large scale analysis are few, and rarely do they expand on gender difference or incarcerated hernias. Methods: Patients with unilateral or bilateral inguinal hernia who were admitted to our hospital and received open inguinal hernia repair (OIHR) or laparoscopic inguinal hernia repair (LIHR) under general anesthesia were included. Medical records were retrospectively collected and analyzed.Results: A total of 12190 patients were included in this study. The ratio of male to female was 4.8:1. There was a total of 10646 unilateral hernias (87.3%) and 1544 bilateral hernias (12.7%), with a corresponding ratio of 6.9:1. 12444 hernia repair surgeries, 11083 (89.1%) OIHR and 1361 (10.9%) LIHR, were held. OIHR had a shorter operative time than LIHR for all unilateral and female bilateral repair, unlike for bilateral male repair. There was no difference between OIHR and LIHR for ipsilateral recurrent hernia in males. There was a difference between OIHR and LIHR for metachronous contralateral hernia.Incarcerated inguinal hernia was associated with longer operative time, hospital stay and higher hospital costs. Females and patients under 1 year were more likely to present with incarcerated hernia.Conclusions: OIHR should be considered for male patients, especially for unilateral and complete inguinal hernia. LIHR is highly recommended for female patients. For incarcerated hernia, attention should be paid to patients under 1 year old, as they can be 60 times more susceptible, and females. Surgeons should also be aware of ovary hernias in females.

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Two-center Analysis of Long-term Outcomes after High Ligation Inguinal Hernia Repair in Adolescents

The American Surgeon ◽

10.1177/000313481508101229 ◽

2015 ◽

Vol 81 (12) ◽

pp. 1260-1262 ◽

Cited By ~ 4

Author(s):

Alessandra C. Gasior ◽

E. Marty Knott ◽

Arielle Ranters ◽

Shawn D. Peter ◽

Todd A. Ponsky

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Recurrent Hernia ◽

High Ligation ◽

Long Term Outcomes ◽

Recurrence Rates ◽

Hernia Sac ◽

Telephone Surveys ◽

Low Incidence

High ligation of the inguinal hernia sac is standard practice for many pediatric surgeons in post-pubertal adolescents. Most adult surgeons do not use this technique to repair indirect inguinal hernias because of concerns for higher recurrence rates compared with mesh repairs. Therefore, we examined long-term outcomes of adolescent high ligation hernia repair performed by pediatric surgeons. Telephone surveys were conducted on children over 12 years old at the time of repair, and patients and/or their parents were contacted 18 months postrepair. Patients were identified from two institutions between 1998 and 2010. The incidences of reoperation, recurrence, presence of bulge, chronic pain, or numbness were determined. A total of 210 patients (40.7% response rate) were available for phone interviews at 18.6 to 159.5 months postrepair. Mean age was 14.6 ± 1.8 (range: 12.0–19.0 years). Fourteen patients had pain (6.7%) and five had numbness (2.4%). There were four (1.9%) patients with a second operation, two of which confirmed a recurrent hernia. Three patients expressed concern about possible recurrence. Two report a bulge, but have not been evaluated. Pediatric hernia repair with high sac ligation appears effective in patients anatomically similar to adults with low recurrence rate and low incidence of chronic symptoms. These data suggest that prospective trials on the adequacy of high ligation in adults are warranted.

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Characteristics and treatments for pediatric ordinary and incarcerated inguinal hernia based on gender: 12-year experiences from a single center

BMC Surgery ◽

10.1186/s12893-020-01039-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Kai Wang ◽

Sarah Siyin Tan ◽

Yue Xiao ◽

Zengmeng Wang ◽

Chunhui Peng ◽

...

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Large Scale ◽

Operative Time ◽

Hospital Costs ◽

Recurrent Hernia ◽

Incarcerated Hernia ◽

Incarcerated Inguinal Hernia ◽

Large Scale Analysis

Abstract Background Congenital primary inguinal hernia is a common condition among children. Although much literature regarding inguinal hernia is available, large scale analysis are few, and rarely do they expand on gender difference or incarcerated hernias. Methods Patients with unilateral or bilateral inguinal hernia who were admitted to our hospital and received open inguinal hernia repair (OIHR) or laparoscopic inguinal hernia repair (LIHR) under general anesthesia were included. LIHR was performed using single-site laparoscopic percutaneous extraperitoneal closure (SLPEC). Medical records were retrospectively collected and analyzed. Results A total of 12,190 patients were included in this study. The ratio of male to female was 4.8:1. There was a total of 10,646 unilateral hernias (87.3%) and 1544 bilateral hernias (12.7%), with a corresponding ratio of 6.9:1. 12,444 hernia repair surgeries, 11,083 (89.1%) OIHR and 1361 (10.9%) LIHR, were held. OIHR had a shorter operative time than LIHR for all unilateral and female bilateral repair, unlike for bilateral male repair. There was no difference between OIHR and LIHR for ipsilateral recurrent hernia in males. There was a difference between OIHR and LIHR for metachronous contralateral hernia. Incarcerated inguinal hernia was associated with longer operative time, hospital stay and higher hospital costs. Females and patients under 1 year were more likely to present with incarcerated hernia. Conclusions OIHR should be considered for male patients, especially for unilateral and complete inguinal hernia. LIHR is highly recommended for female patients. For incarcerated hernia, attention should be paid to patients under 1 year old, as they can be 60 times more susceptible, and females. Surgeons should also be aware of ovary hernias in females.

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Characteristics and Treatments for Pediatric Ordinary and Incarcerated Inguinal Hernia Based on Gender: 12-Year Experiences from a Single Center

10.21203/rs.3.rs-35681/v2 ◽

2020 ◽

Author(s):

Kai Wang ◽

Sarah Siyin Tan ◽

Yue Xiao ◽

Zengmeng Wang ◽

Chunhui Peng ◽

...

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Operative Time ◽

Large Population ◽

Hospital Costs ◽

Recurrent Hernia ◽

Incarcerated Hernia ◽

Incarcerated Inguinal Hernia ◽

Different Characteristics

Abstract Background: To describe the different characteristics of pediatric inguinal hernia in a large population for both genders based on our 12-year experience, and to accordingly recommend one of the two commonly used methods of hernia repair: the traditional open inguinal hernia repair (OIHR) and laparoscopic inguinal hernia repair (LIHR). An additional goal was to describe the characteristics of incarcerated inguinal hernia.Methods: Patients with unilateral or bilateral inguinal hernia who were admitted to our hospital and received OIHR or LIHR under general anesthesia were included. Medical records were retrospectively collected and analyzed.Results: A total of 12190 patients were included in this study. The ratio of male to female was 4.8:1. There was a total of 10646 unilateral hernias (87.3%) and 1544 bilateral hernias (12.7%), with a corresponding ratio of 6.9:1. 12444 hernia repair surgeries, 11083 (89.1%) OIHR and 1361 (10.9%) LIHR, were held. OIHR had a shorter operative time than LIHR for all unilateral and female bilateral repair, unlike for bilateral male repair. There was no difference between OIHR and LIHR for ipsilateral recurrent hernia in males. There was a difference between OIHR and LIHR for metachronous contralateral hernia.Incarcerated inguinal hernia was associated with longer operative time, hospital stay and higher hospital costs. Males and patients under 1 year were more likely to present with incarcerated hernia.Conclusions: OIHR should be considered for male patients, especially for unilateral and complete inguinal hernia. LIHR is highly recommended for female patients. For incarcerated hernia, attention should be paid to patients under 1 year old, as they can be 60 times more susceptible, and females. Surgeons should also be aware of ovary hernias in females.

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A prospective comparative study of outcome between open lichtenstein versus laparoscopic repair of inguinal hernia

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20211879 ◽

2021 ◽

Vol 9 (5) ◽

pp. 1417

Author(s):

Sushila Choudhary ◽

Hitesh Soni ◽

Jagdish M. Mehta ◽

Saurabh Kalia

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Operative Time ◽

Open Repair ◽

Laparoscopic Hernia Repair ◽

Laparoscopic Group ◽

Usual Activity ◽

Time Duration ◽

Post Operative Pain ◽

Hospital Stays

Background: Laparoscopic hernia repair is technically difficult and has long learning curve than open repair. Moreover, with increased cost of procedure do patient really get benefited in terms of intraoperative time duration, post-operative pain and complications, length of hospital stays, and time taken to return to usual activity needs to be studied.Methods: In this prospective observational study of 100 patients including unilateral, bilateral, direct and indirect inguinal hernia and excluding obstructed and strangulated hernia, 61 patients underwent open repair and 39 patients underwent laparoscopic hernia repair. Pain analysis was done with visual analogue scale. Unpaired student T test and Chi square test used (p<0.05).Results: Baseline characteristics age, sex of the two groups were similar. Mean operative time in laparoscopic group was 105.38±35.13 minutes and in open group was 79.95±31.12 minutes (p<0.001). There was statistically significant difference in mean pain score of laproscopic verses open techniques (p<0.001). Urinary retention was the most common post-operative complication in both groups but was statistically not significant. Mean hospital stay in laparoscopic group was 1.56±0.50 days and in open group was 1.9±0.50 days (p-0.002). Mean time taken to return to usual activity in open repair was 41.10±27.15 days and in laparoscopic group was 16.23±6.37 days (p-0.001).Conclusions: This study showed that in laparoscopic repair of inguinal hernia patients have less post-operative pain, shorter hospital stays and early return to work. However, the laparoscopic technique had longer operative time duration.

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