Introduction. Laparoscopic treatment of inguinal hernia is gaining popularity in many hospitals, but the use of working channel scopes is not as widely extended. We present our long-term experience with the SuPerLap (laparoscopic-assisted percutaneous suture) technique described by Rosell et al. (1) for epigastric hernia repair in the percutaneous, single-port treatment of inguinal hernia using working channel scopes. Materials and methods.A retrospective analysis of a series of male patients with congenital inguinal hernia undergoing surgery from February 2017 to December 2020 was carried out. A 5 mm-0º pleuroscope with a 3.5 mm working channel, a 20 G epidural needle, a 36 cm/3.5 mm laparoscopic Maryland dissector, and 3-0 polypropylene and polyester sutures were used.Results. 384 inguinal hernia repairs using the SuPerLap technique were performed in 295 male patients -206 unilateral repairs and 89 bilateral repairs. In 24 bilateral cases (26.95%), preoperative diagnosis had been unilateral. Mean age was two years (2 weeks-13 years). Mean operating time was 14 minutes (6-50 min) for unilateral repair, and 27 minutes (14-80 min) for bilateral repair. There were two cases of epigastric vessel damage, and one case of early recurrence in a newborn, who successfully underwent re-intervention using the SuPerLap technique. No late complications were recorded after a mean follow-up of 1-36 months.Conclusions. Working channel scopes using the SuPerLap technique avoid additional ports in inguinal hernia repair. They allow for excellent functional results, without visible scars, and minimize spermatic cord manipulation. Laparoscopy allows previously undiagnosed defects to be concomitantly treated.
R.A. Hernández-Rodríguez y cols.CIRUGÍA PEDIÁTRICA ResumenObjetivos. La laparoscopia en el tratamiento de la hernia inguinal está cada vez más presente en muchos hospitales. El uso de ópticas con canal de trabajo no está tan extendido. Se presenta la experiencia a largo plazo en la aplicación de la técnica SuPerLap (sutura percutánea laparoasistida) propuesta por Rosell y cols. (1) para la reparación de hernias epigástricas en el tratamiento monopuerto, percutáneo de las hernias inguinales mediante el uso de ópticas con canal de trabajo.Material y método. Serie quirúrgica de hernia inguinal congénita en varones (febrero de 2017-diciembre de 2020). Se utilizó: pleuroscopio de 5 mm-0º con canal de trabajo de 3,5 mm; aguja epidural 20 G; suturas de polipropileno y poliéster 3/0; disector Maryland laparoscópico (36 cm-3,5 mm).Resultados. Se realizaron 384 herniorrafias inguinales según técnica SuPerLap en 295 varones (206 unilaterales, 89 bilaterales). En 24 casos bilaterales (26,95%) el diagnóstico preoperatorio fue unilateral. La edad media fue de dos años (2 semanas-13 años). El tiempo medio quirúrgico fue 14 minutos (6-50 min) en unilaterales, 27 (14-80 min) en bilaterales. Hubo dos casos de lesión de vasos epigástricos y una recidiva precoz en un neonato, reintervenido satisfactoriamente mediante técnica SuPer-Lap. En un seguimiento de 1-36 meses no hubo complicaciones tardías.Conclusiones. El uso de ópticas con canal de trabajo según técnica SuPerLap posibilita prescindir de puertos adicionales en el tratamiento de la hernia inguinal. Permite resultados funcionales comparables y cirugía sin cicatrices visibles. Minimiza la manipulación del cordón espermático. La laparoscopia permite el tratamiento concomitante de defectos no diagnosticados previamente.
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