A human case study demonstrating the safety and effectiveness of laparoscopic surgical glue injection hernioplasty for pediatric indirect inguinal hernia

Abstract

a b s t r a c tThe purpose of this pediatric case report was to provide clinical evidence supporting the safety and effectiveness of laparoscopic surgical glue injection hernioplasty (LSGIH) in humans for indirect inguinal hernia repair. We performed LSGIH on a female newborn for a right indirect inguinal hernia that was incidentally discovered during a laparoscopic right salphingo-oophorectomy for prenatal right ovarian cyst torsion. Under laparoscopic control, the internal ring was closed by injection of Histoacryl Ò into the internal opening of the patent processus vaginalis. One month later, the patient underwent another laparoscopic operation due to torsion of a newly developed contralateral ovarian cyst. During the second operation, we were able to clearly observe the previous LSGIH site. Despite partial absorption of the injected Histoacryl Ò , the opening of the internal ring remained closed without any evidence of adhesions. This case supports LSGIH as a simple, safe, and useful technique for pediatric inguinal hernioplasty. However, more clinical trials should be performed to confirm the long-term reliability and safety of LSGIH in humans.

Comparison of Surgical Outcomes of Laparoscopic Glue and Laparoscopic Suture Hernioplasty in Pediatric Female Inguinal Hernia

“…In previous studies, Kato and Ayman reported that the use of glue was effective in the repair of inguinal hernia, with no recurrence on long-term follow-up, no damage to spermatic cord structures, and no clear impact on fertility [18,41]. Similarly, in our study, the glue was partially absorbed after LGH, which was confirmed by a second surgery due to ovarian torsion, where the glue injection site remained completely closed, without any intraperitoneal organ adhesion [42]. In contrast, Miyano et al reported concerns on the increased risk of intestinal obstruction by adhesive syndrome, hernia recurrence, postoperative hydrocele, and long-term carcinogenesis [24].…”

Laparoscopic Injection of Tissue Adhesives for Inguinal Hernia Repair in a Rabbit Model: Results of an Experimental Comparative Study with the Standard Laparoscopic Inguinal Hernia Repair

“…6 Despite these concerns, Park et al reported very promising results with laparoscopic surgical glue injection hernioplasty in children. 18,19 Their method required only one working port and one camera port and b-CNA glue was adopted to close the defect after the mesothelial layer surrounding the internal inguinal ring was electrically cauterized. The main limitation of this study was that it did not include male patients to avoid potential damage to the vas deferens.…”