scholarly journals Video-assisted percutaneous hernia sac suturing: a new technique of inguinal hernia repair in children

2020 ◽  
Vol 10 (4) ◽  
pp. 411-418
Author(s):  
Pavel M. Pavlushin ◽  
Alexey V. Gramzin ◽  
Nikolai V. Krivosheenko ◽  
Yuri Y. Koinov ◽  
Yuri V. Chikinev
Keyword(s):  
Inguinal Hernia ◽  
Minimally Invasive ◽  
Premature Infants ◽  
Operating Time ◽  
Minimal Invasive ◽  
Bilateral Hernia ◽  
Hernia Sac ◽  
Hernial Sac ◽  
Video Assisted ◽  
A New Technique

Background. Inguinal hernias are very important problem in pediatric surgery. It appears in 520 cases in every 1000 newborns, approximately 10 times prevalence in males. However, the incidence of inguinal hernia is bigger by 1.52 times in group of premature infants. Materials and methods. In prospective study, that was performed in 20192020, 90 pediatric patients diagnosed inguinal hernia were included. All patients had open herniotomy (Duhamel method), subcutaneous endoscopic-assisted ligation of inguinal hernia using Tuohy needle, or video-assisted percutaneous hernial sac suturing (VIPS). Results. The mean operating time in VIPS group was 13 13.46 min in patients with unilateral inguinal hernia and 20 6.12 min in patients with bilateral variant. In the 6-month follow-up period, any complications or recurrences were not observed. VIPS group included two extremely premature infant with uni- and bilateral inguinal hernia. Minimally invasive herniotomy was performed in 50 weeks post-conceptual age, with unremarkable postoperative period. A difference was found in the operating time between groups of minimally invasive herniotomy and group of Duhamel repair. No difference was found in the operating time of bilateral hernia between all groups. Conclusion. Considered all things, assuming that announced method of video-assisted percutaneous hernial sac ligation to be a perspective minimal invasive way of treatment for inguinal hernia in children is reasonable. However, for final conclusions, further study of this surgical technique, also in a cohort of premature infants, is required, with the possible organization of multicenter clinical trials.

scholarly journals Video-assisted isolated percutaneous hernia sac suturing in children with inguinal hernia (VIPS)

2021 ◽  
Vol 10 (2) ◽  
pp. 157-164
Author(s):  
Pavel M. Pavlushin ◽  
Alexey V. Gramzin ◽  
Artyom A. Tratonin ◽  
Nikolai V. Krivosheenko ◽  
Yuri Yu. Koinov ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Operating Time ◽  
Subcutaneous Fat ◽  
Oblique Muscle ◽  
Hernia Sac ◽  
Video Assisted ◽  
Minimally Invasive Surgical ◽  
Inguinal Hernias ◽  
Minimally Invasive Surgical Treatment ◽  
Internal Oblique

Background. Inguinal hernias in children are a common problem. They occur in 520 cases of 1000 newborns, with the prevalence in males of about 10 times. Therefore, they present a very important problem in pediatric surgery. Materials and methods. This prospective study was performed from 2019 to 2020 and included 30 patients with diagnosed inguinal hernias. Video-assisted percutaneous hernia sac ligation was performed in all patients. Results. The mean operating time was 10.3 2.7 min in patients with unilateral inguinal hernias and 14.7 1.6 min in patients with the bilateral variant. No complications or recurrences were observed during the six-month follow-up period. In one case, an additional 3 mm port setting was performed in an eight-month-old child. The main reason for doing this was the fibrous transformation of the parietal peritoneum because of the existence of incarcerations in the anamnesis. Conclusion. This technique garners all the advantages of a minimally invasive surgical treatment of inguinal hernias using the Tuohy needle. However, the conductor application allows us to create the same approach using a Touhy needle. This means that we can perform an isolated hernia sac ligation without getting under the preperitoneal tissue ligature, parts of the internal oblique and transverse muscles, aponeurosis of the external oblique muscle, and subcutaneous fat. This presented video-assisted percutaneous hernia sac ligation method seems like a potential minimally invasive way to treat inguinal hernias in children.

scholarly journals Minimally Invasive Video-assisted Thyroidectomy vs Conventional Open Hemithyroidectomy in Asian Patients

2016 ◽  
Vol 8 (3) ◽  
pp. 189-192
Author(s):  
Reyaz M Singaporewalla ◽  
Anil D Rao ◽  
Arunesh Majumder
Keyword(s):  
Postoperative Pain ◽  
Minimally Invasive ◽  
Pain Score ◽  
Open Surgery ◽  
Operating Time ◽  
Incision Length ◽  
Video Assisted ◽  
Asian Patients ◽  
Significant Difference ◽  
Conventional Open Surgery

ABSTRACT Introduction Although the technique of minimally invasive video assisted thyroidectomy (MIVAT) is well established in continental Europe, data on it's role in Asian patients is limited. We compared the results of MIVAT with conventional open hemithyroidectomy in Asian patients. Materials and methods Over a 1-year period, patients undergoing hemithyroidectomy for benign symptomatic goiters were selected. Inclusion criteria for MIVAT were benign colloid goiters, recurrent cysts or follicular lesions and neoplasms with lobe volume of less than 40 cc or nodule diameter less than 35 mm. Larger goiters underwent conventional open surgery. Patients with previous neck surgery and proven malignancy were excluded. Operative time, complications, postoperative pain score, incision length and cosmetic satisfaction at 6 months were recorded. Results Thirty-six patients (MIVAT-21, Conventional-15) were included. Both groups were comparable in terms of demographic profile and co-morbidities. The mean operating time for both groups showed no significant difference (MIVAT = 111.67 ± 19.4 min, Conventional = 112.40 ± 25.06 min; p = 0.925). Minimally invasive video assisted thyroidectomy patients had significantly less pain in the immediate postoperative period (mean pain score 2.38 vs 4.8, p < 0.001). Mean incision length at end of surgery was significantly smaller in the MIVAT group (2.58 vs 6.3 cm; p < 0.001). Neck scar satisfaction at 6 months was excellent in 71.4% of MIVAT cases vs 26.6% of conventional hemithyroidectomy cases. There were no complications in any of the treatment groups. Conclusion In selected cases, MIVAT is as safe as conventional open surgery with distinct advantages of better postoperative pain control and cosmesis. How to cite this article Rao AD, Singaporewalla RM, Majumder A. Minimally Invasive Video-assisted Thyroidectomy vs Conventional Open Hemithyroidectomy in Asian Patients. World J Endoc Surg 2016;8(3):189-192.

scholarly journals Minimally invasive, video-assisted thyroidectomy: first experience from the United Kingdom

2010 ◽  
Vol 92 (5) ◽  
pp. 379-384 ◽  
Author(s):  
AK Samy ◽  
D Ridgway ◽  
A Orabi ◽  
A Suppiah
Keyword(s):  
Minimally Invasive ◽  
Objective Assessment ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Operating Time ◽  
Rapid Improvement ◽  
Voice Change ◽  
Video Assisted ◽  
Surgeon Experience ◽  
First Results ◽  
The Uk

INTRODUCTION Minimally-invasive, video-assisted thyroidectomy (MIVAT) was developed to reduce scarring/trauma associated with cervical incisions used in open thyroidectomy. Results from various centres have been published internationally but none from the UK. This study reports the first results from the UK and compares them with other centres. We also aim to compare the results of a single-surgeon experience in a small/moderately-sized hospital to those of larger tertiary centres. PATIENTS AND METHODS Retrospective analysis of a single surgeon experience in a district general hospital RESULTS The cohort was 55 patients (52 female, 3 male), mean age 48 years (range, 21-77 years) who had 64 MIVAT procedures. There were 49 hemithyroidectomies (HTs), 2 isthmusectomy, 4 total thyroidectomies (TTs) and 9 completion thyroidec-tomies (CTs) with median operating time of 86 min (IQR 66-110 min). Individual operating times were HT 85 min (IQR 60-110 min); TT 130 min (IQR 100-140 min) and CT 77 min (IQR 70-98 min). Median operating time was shorter in the second half of this series (76 min vs 92 min; P < 0.001). Length of stay was < 1 day in 92%. Conversions occurred in 6.3% with no haematoma or re-operation. Transient voice change was present in 7 (11%), permanent unilateral recurrent laryngeal nerve palsy in 2 (3%), and transient hypocalcaemia in 2 (3%). CONCLUSIONS The first results from the UK are similar to those of other international centres. A single-surgeon practice can obtain results comparable to larger tertiary centres provided there is sufficient case-load. MIVAT is safe and effective, but has a steep learning curve with rapid improvement observed within first 30 cases. Future studies should focus on objective assessment of scar/cosmesis and cost-effectiveness. MIVAT is an acceptable alternative to open surgery in highly selected patients.

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

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.

scholarly journals Two Ports Laparoscopic Inguinal Hernia Repair in Children

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Medhat M. Ibrahim
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Operative Time ◽  
Laparoscopic Hernia Repair ◽  
Recurrent Hernia ◽  
Bilateral Hernia ◽  
Hernia Sac ◽  
Treatment Techniques ◽  
The Mean ◽  
Open Hernia Repair

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.

scholarly journals Twelve-years’ experience in minimal invasive Achilles tendon repair using a suture-guiding device

2019 ◽  
Vol 26 (2) ◽  
pp. 89-94
Author(s):  
Prisca Yeung ◽  
Lok Pong Man ◽  
Wing Hang Angela Ho
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Plantar Flexion ◽  
Achilles Tendon Rupture ◽  
Operating Time ◽  
Tendon Repair ◽  
Minimal Invasive ◽  
Achilles Tendon Repair ◽  
Invasive Method ◽  
The Mean

Introduction: Minimal invasive Achilles tendon repair is becoming more and more popular recently. We have evaluated our results in Achilles tendon repair using minimally invasive method by a suture-guiding device. Methods: This is a retrospective review of patients with acute Achilles tendon rupture, which was repaired using minimally invasive method namely the suture-guiding device, that was performed during 2003 to 2015 in our department. Outcome parameters were the incidence of re-rupture, other complications, and the functional outcome. Results: There were 36 men (90%) and 4 women (10%) in this study. Mechanisms of injury were basketball (28%), football (15%), squash (15%), and trauma (13%). The mean operating time was 59 min (range 30–90 min). The mean follow-up time was 8 months (range 3–35 months). The mean duration with casting was 7 weeks. The mean range of movement at 3 months was 8° dorsiflexion and 33° plantar flexion. There was no major complication necessitating surgical re-interventions such as re-ruptures and infections. No patient suffered from dysfunction of the sural nerve or delay wound healing. Conclusion: Minimally invasive Achilles tendon repair using suture-guiding device is a safe and quick procedure with a low rate of re-rupture and a satisfactory short-term and long-term recovery. Level of evidence: IV.

scholarly journals The application of scrotoscope-assisted minimally invasive excision for epididymal mass: an initial report

2021 ◽  
Author(s):  
Chuying Qin ◽  
Jinrui Yang ◽  
Ruochen Zhang ◽  
Yaojing Yang ◽  
Wanghai Cai ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Demographic Data ◽  
Operating Time ◽  
General Information ◽  
Minimal Invasive ◽  
Invasive Treatment ◽  
Initial Report ◽  
Effective Option ◽  
Minimal Invasive Treatment ◽  
Open Excision

Abstract Background Traditional open excision of epididymal mass is a non-minimal invasive treatment and brings relatively more postoperative discomfort and complications. To solve this problem, we apply scrotoscope to treat epididymal mass and compare the middle-term efficacy and safety results between scrotoscope-assisted (SA) minimally invasive excision and traditional open excision (OE) for the treatment of epididymal mass. Methods A total of 253 males with surgery excision of epididymal mass from 2012 to 2018 were included in this retrospective study. The primary outcomes included general information, intraoperative data and postoperative data. Results 174 patients underwent SA and other 79 underwent OE. Demographic data was similar between the two groups. Compared with OE surgery, SA could significantly shorten operating time (19.4 ± 4.1 vs 53.8 ± 12.9 minutes), reduce blood loss (5.3 ± 1.5 vs 21.3 ± 5.6 mL) and downsize the operative incision (1.5 ± 0.3 cm vs 4.5 ± 0.8 cm). Additionally, postoperative complications were significantly less occurred in SA group than those in OE (15.5 % vs 21.5%). Patients in SA group had a significant higher overall satisfaction score (94.8 ± 3.7 vs 91.7 ± 4.9) than that in OE group. Conclusion SA is emerging as a novel and effective option with promising perspectives for epididymal mass therapy.

RESULTS OF THE METHOD OF TOTAL EXTRAPERITONEAL ENDOSCOPIC ASSISTED HERNIA SAC LIGATION IN CHILDREN WITH INGUINAL HERNIA (PHELPS)

2021 ◽  
Vol 100 (4) ◽  
pp. 33-39
Author(s):  
Yu.A. Kozlov ◽  
◽  
P.A. Krasnov ◽  
S.S. Poloyan ◽  
A.N. Narkevich ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
New Technology ◽  
Demographic Data ◽  
Randomized Study ◽  
Total Duration ◽  
Operation Time ◽  
Laparoscopic Treatment ◽  
Hernia Sac ◽  
Hernial Sac ◽  
Total Extraperitoneal

The aim of the study was to evaluate the effectiveness of the new technology for laparoscopic treatment of inguinal hernia (IH) in children (PHELPS) in comparison with the popular extraperitoneal SEAL technique. Materials and methods of research: a retrospective comparative single-center non-randomized study was carried out. The analysis of the results of laparoscopic treatment of 680 patients with IH was performed, out of them 206 patients were operated on using the new PHELPS technique, in 474 cases the laparoscopic extraperitoneal SEAL technique was used. The gender composition of patients in the groups did not differ statistically significantly (m/f: 151/55–73.3%/26,7% versus 349/125–73.6%/26,4%, p=0,929). The median age of children in the PHELPS group was 169,5 [80,8; 261,3] days, in the SEAL group – 210,5 [78,0; 258,0] days (p=0,137). The difference between the new technique for treating IH in children consisted in the method of carrying out a hernial ligature around the neck of the hernial sac in such a way that the knot after percutaneous tying was located at the level of the peritoneum and did not include the tissues of the abdominal wall (aponeurosis and muscles). At the end of the study, a comparison of demographic data, intra- and postoperative results in the two groups of patients was made. Results: the median of the total duration of inguinal herniorrhaphy, including the operation time in patients with single and double sided hernia localization, confirmed statistically unchanged values of this indicator in the comparison groups (20,0 [15,0; 20,0] min versus 15,0 [15,0; 20,0] min, р=0,518). The study demonstrated a faster recovery of patients after using the PHELPS technique for the treatment of IH, with a statistically significantly lower number of doses of postoperative analgesia (1,0 [1,0; 1,0] versus 1,0 [1,0; 2,0 ], p<0,001) and a shorter hospital stay (8,0 [6,0; 8,0] hours versus 8,0 [8,0; 9,0] hours, p=0,031). Despite the fact that there were no statistically significant differences in the frequency of formation of dropsy of the testicle (0 (0,0%) versus 6 (1,3%), p=0,185), a statistically significantly better condition of patients was revealed as a result of the use of the innovative PHELPS technique, consisted in the absence of the return of symptoms of the disease – 0 (0,0%) versus 17 (3,6%), p=0,003. Conclusion: the new PHELPS method of treating IH in children allows to improve the quality of known extraperitoneal methods of treating the disease. The placement of a hernial ligature node at the level of the hernial sac neck, rather than over the aponeurosis, is expected to lead to a decrease in the number of relapses after surgery.

scholarly journals Total extraperitoneal approach in large inguino-scrotal hernias: an institutional approach

2016 ◽  
Vol 18 (3) ◽  
pp. 51 ◽  
Author(s):  
Tuhin Shah ◽  
S Shah ◽  
BR Joshi ◽  
RJ Karkee ◽  
RK Gupta
Keyword(s):  
Inguinal Hernia ◽  
Operating Time ◽  
Operation Time ◽  
Hernia Surgery ◽  
Recurrence Rates ◽  
Hernia Sac ◽  
Tep Repair ◽  
Inguinal Hernia Surgery ◽  
Total Extraperitoneal ◽  
The Mean

Introduction: Since 2 decades laparoscopichernia repair has gained key role in uncomplicated inguinal hernia surgery with advantages showed by several trials and guidelines. However, its role in complicated inguinal hernia such as incarcerated, obstructed and inguino-scrotal is debatable. Cases of large inguino-scrotal raises objection to laparoscopic procedure because of anticipated problems and complications in dissecting extended hernia sac even though posterior approach is advocated as repair of choice for complicated cases. Here, we reviewed our series of patients undergoing TEP in a limited time frame.Method: Between March 2013 and June 2014, 50 consecutive patients underwent TEP repair for inguinoscrotal hernia. Patient demographics, hernia characteristics, operating time, surgical technique, conversion rate, intraoperative, postoperative complications and recurrence was recorded and analyzed using MS Excel.Results: 50 patients were recorded, 26 had unilateral and 24 had bilateral hernias. Mean age was 52 (22-72) years. The mean operation time was 70 (50-140) min. Bilateral repairs took 45% (18 min) longer than for unilateral repairs (52 + 12 min). Two (12.5%) patients required combined open surgery to transect the incarcerated omentum. There was no mortality. Morbidity was limited to asymptomatic seroma formation in 2 (12.5%) patients; 1 patient of combined open-TEP approach had wound infection, both treated conservatively. Mean follow up was 6.3 months; we recorded 2 recurrences (12.5%). The mean length of hospital stay was 1.8 days.Conclusion: We conclude that TEP can be safely employed for complicated inguinal hernias repair. Surgical experience in mandatory with tailored technique to reduce morbidity and achieve good clinical outcome with acceptable recurrence rates.

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