Modifications of surgical techniques in laparoscopic percutaneous extraperitoneal closure of inguinal ring for childhood inguinal hernia to achieve zero recurrence and zero subcutaneous stitch granuloma.

Autor: Son TN; Department of Pediatric Surgery, Saint Paul Hospital, No 12 Chu Van An Street, Ba Dinh District, Hanoi, 100000, Vietnam. drtranson@yahoo.com., Bao HV; Department of Pediatric Surgery, Saint Paul Hospital, No 12 Chu Van An Street, Ba Dinh District, Hanoi, 100000, Vietnam., Van NTH; Department of Pediatric Surgery, Saint Paul Hospital, No 12 Chu Van An Street, Ba Dinh District, Hanoi, 100000, Vietnam., Hiep PD; Department of Pediatric Surgery, Saint Paul Hospital, No 12 Chu Van An Street, Ba Dinh District, Hanoi, 100000, Vietnam., Mai DV; Department of Pediatric Surgery, Saint Paul Hospital, No 12 Chu Van An Street, Ba Dinh District, Hanoi, 100000, Vietnam., Quyet TV; Department of Pediatric Surgery, Saint Paul Hospital, No 12 Chu Van An Street, Ba Dinh District, Hanoi, 100000, Vietnam.
Jazyk: angličtina
Zdroj: Pediatric surgery international [Pediatr Surg Int] 2024 Jul 13; Vol. 40 (1), pp. 187. Date of Electronic Publication: 2024 Jul 13.
DOI: 10.1007/s00383-024-05779-w
Abstrakt: Purpose: To present our technical modifications of single incision laparoscopic percutaneous extraperitoneal closure (SILPEC) of the internal inguinal ring (IIR) for pediatric inguinal hernia (PIH).
Methods: The prospectively collected data of all children diagnosed with PIH undergoing SILPEC at our center from 2016 to 2023 were reviewed and divided into two groups for result comparison: Group A: before and Group B: after the implementation of full modifications. Our modifications included using a nonabsorbable monofilament suture, creating a peritoneal thermal injury at the internal inguinal ring (IIR), employing a cannula to ensure the suture at the IIR ligates only the peritoneum, and double ligation of the IIR in selected cases.
Results: 1755 patients in group A and in group B (1 month to 14 years old) were enrolled. There were no significant differences regarding baseline patient characteristics between the two groups. At a median follow-up of 40 months, the rate of recurrent CIH and subcutaneous stitch granuloma (SSG) was 2.3% and 1.5% in group A vs. 0% and 0% in group B (p < 0.001). There were no hydroceles, no ascended or atrophic testis.
Conclusions: Our SILPEC technical modifications can achieve zero recurrence and zero SSG for PIH.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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