Needlescopic assisted internal ring suturing; a novel application of low-cost home-made instruments for pediatric inguinal hernia repair

Shalaby, Rafik; Elsaied, Adham; Shehata, Sameh; Shehata, Sh; Hamed, Ashraf; Alsamahy, Omar; Ashour, Yasser; Elsayaad, Ibrahim Mahmoud; Shahin, Mohamed M.

doi:10.1007/s10029-019-01982-0

Cited by 14 publications

(18 citation statements)

References 29 publications

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“…18 When compared with the intracorporeal purse suture technique, percutaneous extracorporeal closure was shown to have a significant reduction in operating time. 9,13,16,17 In this study, the mean operating time was 42 minutes for unilateral repair and 46 minutes for bilateral repair. As surgical experiences were accumulated, the operating time gradually decreased (Fig.…”

Section: Discussionmentioning

confidence: 79%

“…In the literature, needlescopic instruments or puncture needles were mostly used in the extracorporeal technique. [13][14][15][16] On the other hand, Schier reported a large series of patients who underwent a laparoscopic intracorporeal suture repair using 2-mm instruments. 17 He closed the internal ring with a single N-shaped suture instead of a purse-string suture.…”

Section: Discussionmentioning

confidence: 99%

“…[9][10][11][12] Such intracorporeal suture is a basic procedure in laparoscopic surgery but requires adequate experience for satisfactory performance. 13 On the other hand, extracorporeal techniques involve suturing the inner ring with a specialized needle instrument inserted percutaneously, where the knot is subcutaneously located outside the fascia. 8 We performed laparoscopic intracorporeal purse-string suture using a combination of one 5-mm and two 2-mm instruments for pediatric inguinal hernia repair.…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic Pediatric Inguinal Hernia Repair; Intracorporeal Purse-String Suture Using Needlescopic 2-mm Instruments

Lim

Chang

Park

2020

J Minim Invasive Surg

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Two-millimeter needlescopic instruments induce minimal damage to the abdominal wall and have excellent cosmetic benefits. We aimed to evaluate the feasibility of a laparoscopic intracorporeal suture using 2-mm instruments for pediatric inguinal hernia. Methods:We retrospectively reviewed 131 patients who underwent laparoscopic repair between March 2011 and February 2017. Three trocars were used: a 5-mm umbilical trocar for a needle holder and two 2-mm trocars for a camera and a grasper. The internal ring was closed with an intracorporeal purse-string suture. A telephone interview was conducted to confirm recurrence. Results:In the 131 patients, 169 procedures were successfully performed. The ages ranged from 2 months to 14 years (mean, 52.5 months), and the mean body weight was 18.0 kg (range, 6.7~49 kg). The mean operating time was 42 minutes for the unilateral cases and 46 minutes for the bilateral inguinal hernia repairs. All the cases were completed laparoscopically without intraoperative complications. Herniotomy was not performed in all the patients except nine. A contralateral patent processus vaginalis was present in 27.3% (35/128) of the patients. During the mean follow-up period of 54.6 months, 3 recurrences (2.3%) were observed. Two recurrences were treated using laparoscopy and one using open herniorrhaphy. Hydrocele occurred in one male patient. No wound complications or umbilical hernias developed. No testicular atrophy was observed. Conclusion:This study showed that laparoscopic intracorporeal internal ring suture using 2-mm instruments for pediatric inguinal hernia was technically feasible and safe, with excellent cosmetic results.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Laparoscopic Pediatric Inguinal Hernia Repair; Intracorporeal Purse-String Suture Using Needlescopic 2-mm Instruments

Lim

Chang

Park

2020

J Minim Invasive Surg

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“…All surgical procedures have a common feature, dealing with the internal ring. Most of the pediatric surgery scholars believe that although the peritoneal processus vaginalis is possible to close after the birth of a child, indirect inguinal hernia rarely heals spontaneously, so surgery is recommended as soon as diagnosed [24] . Infants have a high chance of getting indirect inguinal hernia incarceration due to frequent crying, increased intra-abdominal pressure, and family members lacking medical knowledge or other reasons.…”

Section: Surgical Treatment Of Indirect Inguinal Hernia In Childrenmentioning

confidence: 99%

Development and current status of treatment for pediatric indirect inguinal hernia

Zhifeng¹,

Yuanfei²,

HE³

et al. 2020

MRHK

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To investigate the development and current status of the treatment of pediatric indirect inguinal hernia. Inguinal hernias include indirect hernias and direct inguinal hernias, but there are almost indirect inguinal hernias in children . Pediatric indirect inguinal hernia that the most common disease in pediatric surgery is almost caused by patent processus vaginali which incidence ranges from 0.8% to 4.4%.The treatment of pediatric indirect inguinal hernia reflects the process of pediatric surgery development, which from conservative non-surgical treatment to high ligation of the longitudinal incision hernia sac. In recent years, with the continuous improvement of medical level in China, laparoscopic technique has been applied in hospitals all over China, and laparoscopic high ligation of indirect inguinal hernia sac has become the standard for the treatment of pediatric indirect inguinal hernia.

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“…However, according to the literature, infection, pain, palpable thread knot and other adverse events associated with extraperitoneal knotting could occur in classical SLPEL procedure 2,6,8 . Twice punctures of the abdominal wall might be the main cause.…”

Section: Introductionmentioning

confidence: 99%

Modification of the Classical Percutaneous Extraperitoneal Procedure for Pediatric Inguinal Hernia to Reduce Complications: A Multiple-Centered Comparison Study

Luo

Shi

et al. 2021

Preprint

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Single-site laparoscopic percutaneous extraperitoneal ligation (SLPEL) for pediatric inguinal hernia gained popularity all over the world. However, complications associated with extraperitoneal knotting were not rare in the classical SLPEL(C-SLPEL) procedure. In order to overcome disadvantages, we herein developed the modified SLPEL (M-SLPEL) procedure, intact circuit ligation of the peritoneum around the internal ring using a homemade hernia needle with a single abdominal wall centesis. To evaluated the effectiveness of the M-SLPEL procedure to decrease adverse events associated with ligation knotting, a comparative study was carried out. A total of 3219 patients from multiple centers were divided into two groups according to the operative procedures: M-SLPEL group and C-SLPEL group. All patients were followed up. Data describing the clinical characteristics, operative time, postoperative hospital stay, and complications was collected and retrospectively analyzed. With equivalent operative time, postoperative hospital stay, there was statistically significant difference between two groups in terms of the overall complications incidence (2.6% in C-SLPEL Vs 0.11% in M-SLPEL, P=0.03), including pain in inguinal area, knot foreign body reaction, palpable knot, recurrence. Together, these findings suggest that the M-SLPEL procedure is an effective and safe approach, with unique advantage in reducing adverse events in the inguinal region.

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Needlescopic assisted internal ring suturing; a novel application of low-cost home-made instruments for pediatric inguinal hernia repair

Cited by 14 publications

References 29 publications

Laparoscopic Pediatric Inguinal Hernia Repair; Intracorporeal Purse-String Suture Using Needlescopic 2-mm Instruments

Laparoscopic Pediatric Inguinal Hernia Repair; Intracorporeal Purse-String Suture Using Needlescopic 2-mm Instruments

Development and current status of treatment for pediatric indirect inguinal hernia

Modification of the Classical Percutaneous Extraperitoneal Procedure for Pediatric Inguinal Hernia to Reduce Complications: A Multiple-Centered Comparison Study

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