Percutaneous Internal Ring Suturing: A Simple Minimally Invasive Technique for Inguinal Hernia Repair in Children

Abstract

The percutaneous internal ring suturing method seems to be a simple and effective minimally invasive procedure with excellent cosmetic results. The rate of complications is comparable to other laparoscopic techniques of inguinal hernia repair in children. According to our experience, percutaneous internal ring suturing should be considered as a treatment alternative.

Effects of Laparoscopic Hernia Repair by PIRS (Percutaneous Internal Ring Suturing) Technique on Testicular Artery Blood Supply

“…First reports of PIRS technique had been associated with higher rates of ipsilateral recurrence and residual hydroceles 3,4 This had been attributed to several factors such as the inexperience of the surgeons, the use of absorbable suture, the use of a single suture or larger defects. More recent publications report lower recurrence and complications rate.…”

Scarless laparoscopic repair of epigastric hernia in children

“…Without exposing the fascial defect they performed five stitches using a 20 G epidural needle. The technique for suture was the same as described above, which is inspired in the percutaneous Internal ring suture (PIRS) described by Patkowski et al [4]. Although no conclusion can be taken by a single successful repair, we believe that the absence of a clear visualization of the fascial defect might favor failure of the hernia repair.…”

Ultrasound-guided dissection and ligation of the internal inguinal ring for hernia repair in pediatrics: an experimental animal study

“…As the techniques evolve, new strategies have been applied, as the use of natural orifices, robotically assisted procedures and percutaneous laparoscopic assisted procedures, in a quest to be even less invasive. While the open techniques for indirect inguinal hernia correction, a common procedure in pediatric surgery, are well established and have had their own evolution, laparoscopic correction has emerged in this global context [1,2], peaking nowadays for some into a scar less percutaneous procedure [3].Simultaneously, the ultrasound technology has evolved greatly, with the technology becoming more available and being currently used in areas other than radiology and diagnostics. The ultrasound-guided loco-regional anesthesia is a well-established example of the ultrasound utility in a surgical setting [4,5].…”

“…As the techniques evolve, new strategies have been applied, as the use of natural orifices, robotically assisted procedures and percutaneous laparoscopic assisted procedures, in a quest to be even less invasive. While the open techniques for indirect inguinal hernia correction, a common procedure in pediatric surgery, are well established and have had their own evolution, laparoscopic correction has emerged in this global context [1,2], peaking nowadays for some into a scar less percutaneous procedure [3].…”