Laparoscopic single instrument closure of inguinal hernia in female children: A novel technique

Helal, Ahmed Abdelgaffar Elgffar

doi:10.1016/j.jpedsurg.2015.05.003

Cited by 12 publications

(9 citation statements)

References 23 publications

(27 reference statements)

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“…At the moment, single-port and single-incision laparoscopic repair of inguinal hernia has been confirmed. In 2015, Lee et al demonstrated that using laparoscopic purse-string suture around open IIR is enough for pediatric inguinal hernia repair [ 12 – 14 ].…”

Section: Discussionmentioning

confidence: 99%

Single-Incision Percutaneous Closure of Pediatric Inguinal Hernia: A New Modification for Intracorporeal Suture Knotting

Helal

Daboos

Othman

et al. 2020

Minimally Invasive Surgery

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Background. Single-incision percutaneous closure (SIPC) of pediatric inguinal hernia under laparoscopic guidance is a well-developed feasible technique; however, suture knotting remains a major challenge during this technique. Most laparoscopic surgeons prefer extracorporeal subcutaneous suture knotting, which may be associated with consequent formation of stitch sinus and increased recurrence rate. On the other hand, intracorporeal suture knotting necessitates the availability of special devices or homemade instruments with a long learning curve. Therefore, the present study innovates new and simple modification allowing intracorporeal suture knotting during SIPC of pediatric inguinal hernia that does not require any special operating devices or homemade instruments. Patients and Methods. Four-hundred children suffering from inguinal hernia of congenital type, submitted to SIPC using Epidural needle (EN), under laparoscopic guidance with intracorporeal suture knotting. Results. Children ages were 6 months to 10 years (the range). There were 300 boys and 100 girls, and two-hundred children suffered from left side hernia, 150 with right-side hernia, and 50 children with both left- and right-side hernia. 10 ± 2.2 minutes was the recorded operation time in one side hernia repair, while 14 ± 4.3 minutes was recorded for both side repair. Postoperative results reported recurrent hernia in one child and postoperative hydrocele in 3 children which resolved spontaneously after 3 weeks of follow-up. Conclusion. Intracorporeal suture knotting during SIPC of pediatric inguinal hernia allows for the transformation of a formally extraperitoneal procedure to an intraperitoneal procedure. This new modification for intracorporeal suture knotting does not require any special operating devices or homemade instruments. It seems to be an attractive way during SIPC of pediatric inguinal hernia when intracorporeal suture knotting is considered.

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Section: Discussionmentioning

confidence: 99%

Single-Incision Percutaneous Closure of Pediatric Inguinal Hernia: A New Modification for Intracorporeal Suture Knotting

Helal

Daboos

Othman

et al. 2020

Minimally Invasive Surgery

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“…It appears that the cause of recurrence may have been related to a weak point (the superficial purse) in the area above the vas and vessels. Helal [12] published an investigation of a further series of 60 girls with 68 hernias, treated by laparoscopic single instrument closure of inguinal hernia, and reported only one case of recurrence (1.47%). Furthermore, Helal [12] explained that this recurrence may have occurred due to skip areas around the IIR during his learning curve.…”

Section: -26]mentioning

confidence: 99%

Single-incision laparoscopic closure of inguinal hernia in female children: a simplified technique

Helal¹

2017

MIS

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Aim: Single-incision laparoscopic hernia repair (SILHR) is a popular technique, especially in female children, as it reduces the number of incisions while achieving a better cosmetic outcome. However, intracorporeal suturing and knotting remains a major obstacle during SILHR and it requires a relatively long learning curve. Conversely, extracorporeal suturing and knotting is straightforward, though it has several drawbacks. The purpose of this report is to describe a simple technique for SILHR in female children. Methods: Between May 2014 and December 2016, 100 girls with 120 hernias of the Canal of Nuck (34 with right-side inguinal hernia, 46 with left-side hernia, and 20 with bilateral hernia) underwent SILHR. The opened internal inguinal ring was closed using a complete purse string suture fashioned by epidural needle with intracorporeal knot tying. The main outcomes were feasibility, operative time, complications and cosmetic outcome. Results: The mean age was 2.0 ± 2.2 years, and the mean operative time was 8.0 ± 2.2 min for unilateral hernia repair and 16.0 ± 4.3 min for bilateral cases. All cases were completed laparoscopically without intraoperative complications. During follow-up, there were no recurrences and umbilical scars were almost invisible. Conclusion: This simplified technique is feasible, quick, achieves better cosmetic results in female children, and avoids the drawbacks of extracorporeal knotting. Key words:Single incision, intracorporeal knotting, laparoscopic hernia repair, simplified technique, female hernia ABSTRACT Article history:

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“…The overlying skin may be edematous, erythematous, and discolored. On the other hand, the hernia may be huge enough to be easily diagnosed as seen in (Figure 4) [18,19].…”

Section: Clinical Examinationmentioning

confidence: 99%

“…It permits extension of benefits of minimal access surgery. Also, he reported that it reduces operative time especially in bilateral cases and allows for quick return to normal activity of children ( Figure 5) [18,31,32].…”

Section: Intra-corporeal Techniquesmentioning

confidence: 99%

Inguinal Hernia in Infancy and Children

Helal¹

2017

Hernia

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Congenital inguinal hernia is a very important subject for both general and pediatric surgeons, and many issues related to the inguinal hernia in infants and children are still confusing. Herein, the subject of congenital inguinal hernia, including the relevant embryology, related anatomy, the symptoms and signs essential for diagnosis, and the needed examination tests and investigations, is presented in a systematic manner. Also, the updated treatment options were discussed including both open and laparoscopic approaches with spotlight on the very recent single incision laparoscopic inguinal hernia repair in children. Finally, at the end of the chapter, there are many valuable references for more details.

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Laparoscopic single instrument closure of inguinal hernia in female children: A novel technique

Cited by 12 publications

References 23 publications

Single-Incision Percutaneous Closure of Pediatric Inguinal Hernia: A New Modification for Intracorporeal Suture Knotting

Single-Incision Percutaneous Closure of Pediatric Inguinal Hernia: A New Modification for Intracorporeal Suture Knotting

Single-incision laparoscopic closure of inguinal hernia in female children: a simplified technique

Inguinal Hernia in Infancy and Children

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