Risk factors for recurrence and contralateral inguinal hernia after laparoscopic percutaneous extraperitoneal closure for pediatric inguinal hernia

Fukumoto, Koji; Yamoto, Masaya; Nakajima, Hideaki; Sekioka, Akinori; Yamada, Yutaka; Nomura, Akiyoshi; Urushihara, Naoto

doi:10.1016/j.jpedsurg.2016.11.029

Cited by 39 publications

(20 citation statements)

References 17 publications

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“…There were no significant complications, and the recurrence was very rare (0.2%), which was comparable to previously reported LPEC recurrence rates [4–6]. It means the safety of the surgery was ensured during the training.…”

Section: Discussionsupporting

confidence: 85%

The learning curve of laparoscopic percutaneous extraperitoneal closure (LPEC) for inguinal hernia: protocoled training in a single center for six pediatric surgical trainees

et al. 2019

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BackgroundLaparoscopic percutaneous extraperitoneal closure (LPEC) has become a common procedure for repairing inguinal hernia. As a laparoscopic approach, pediatric surgical trainees require more training to learn LPEC than a traditional open approach. This study aimed to clarify the experience needed to acquire the skill to perform LPEC adequately.MethodsThis descriptive single-center study used clinical data from patients who underwent LPEC between May 2009 and May 2016. The mean operative time for ten consecutive unilateral repairs was used as an index of proficiency with the procedure. The number of repairs performed before the mean operative time became less than 20 min was evaluated for each trainee.ResultsDuring the study period, six pediatric surgical trainees participated in the training independently. The number of the patients was 987. The total number of repairs was 1436, including 538 unilateral repairs and 449 concurrent bilateral repairs. Overall, the mean operative time was 21.8 ± 8.1 min for unilateral repair and 31.4 ± 9.7 min for concurrent bilateral repairs. The mean number of repairs performed before the acquisition of skill for dexterous LPEC was 125.1 ± 29.5.ConclusionsAlthough there were individual differences, all trainees acquired the skill to perform LPEC adequately within one year. With appropriate guidance, LPEC can become a standard technique for pediatric surgical trainees, along with traditional open surgery. These results provide valuable information for planning LPEC training.

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Section: Discussionsupporting

confidence: 85%

The learning curve of laparoscopic percutaneous extraperitoneal closure (LPEC) for inguinal hernia: protocoled training in a single center for six pediatric surgical trainees

et al. 2019

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“…The present results showed that the recurrence rate after OR was 1.9% (2/105 hernia repairs), after the denominator of the rate was equalized, making it compatible with those from the previous reports; however, the follow‐up periods in the present study were longer than those in the previous reports. In a large series of LPEC procedures, Miyake et al reported that being male and young (<12 months) were risk factors for recurrence after LPEC; the recurrence rate was 1.8% (5/271 cases) in all infants and 2.5% (5/199 cases) in male infants . Therefore, the recurrence rate after LPEC in the present study could be considered relatively favorable.…”

Section: Discussionmentioning

confidence: 46%

Safety and efficacy of laparoscopic percutaneous extraperitoneal closure for inguinal hernia in infants younger than 6 months: A comparison with conventional open repair

Zenitani

Saka

Sasaki

et al. 2018

Asian J Endoscop Surgery

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Introduction This study aimed to compare the safety and efficacy of laparoscopic percutaneous extraperitoneal closure (LPEC) and conventional open repair (OR) for inguinal hernia in infants younger than 6 months. Methods The medical records of 202 patients who had undergone LPEC or OR at an age younger than 6 months between 2010 and 2016 were reviewed. Patient characteristics and surgical outcomes were compared between LPEC and OR. Results In total, there were 120 LPEC (76 males, 44 females) and 83 OR (76 males, 7 females) cases. There were no differences in median age, median bodyweight, and presence of incarceration between the two groups (LPEC group: 3 months (range, 0–5 months), 5.7 kg (range, 2.3–9.6 kg), and 13.3%; OR group: 3 months (range, 1–5 months), 5.5 kg (range, 2.1–9.0 kg), and 12.0%). LPEC was completed in all cases without any intraoperative complications or open conversions. In the LPEC group, 60.0% of unilateral hernia patients had a contralateral patent processus vaginalis and underwent prophylactic closure. The incidence of metachronous contralateral hernia was significantly lower in the LPEC group than in the OR group (0% vs 10.0%, P < 0.01). Operative time was significantly shorter during LPEC than during OR (P < 0.01) for male patients. The recurrence rate was lower in the LPEC group (0.83%) than in the OR group (2.4%), but the difference was not significant. Conclusion The present data indicate that LPEC is comparable to OR in terms of safety and efficacy in infants younger than 6 months. Moreover, among the LPEC group, there were fewer incidences of metachronous contralateral hernia, and the procedure had a shorter operative time.

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“…This rate is very comparable to previously published recurrence rates of open repair. [19] The same previous study stressed the fact that surgical skill is paramount and in regard to the technique they were using, a surgeon needed to perform 30 cases to acquire the required skills. [19] Interestingly, Shalaby et al .…”

Section: Discussionmentioning

confidence: 99%

“…[19] The same previous study stressed the fact that surgical skill is paramount and in regard to the technique they were using, a surgeon needed to perform 30 cases to acquire the required skills. [19] Interestingly, Shalaby et al . reported a 1.13% recurrence rate in the first 703 cases done in their study, whereas the latter 450 cases had a 0% recurrence rate, an improvement that can be potentially due to the gained experience in the first 703 cases.…”

Section: Discussionmentioning

confidence: 99%

Our Laparoscopic Surgical technique and experience in treating pediatric inguinal hernia over the past decade

Alshammari

Sica

Talon

et al. 2020

J Indian Assoc Pediatr Surg

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Background:Over the past decade, laparoscopic hernia repair was the most performed operation in our department. Equally, it compromises 15% of all pediatric operations performed. We aim, in this study, to review all the cases performed and extrapolate important information like reoccurrences, the incidence of metachronous inguinal hernia, complications amongst other information.Material and Methods:All patients under the age of 18 whom underwent elective laparoscopic hernia repair between 03/01/2007 till the 18/05/2016 were included in our study. We recorded important clinical features and studied their post-operative follow up. Equally reoccurrences, the incidence of metachronous inguinal hernia, complications and other parameters were recorded and studied.Results:A total of 916 patients were operated on during the defined study period. There was a 0.17% reoccurrence rate and a 0.46% incidence of metachronous inguinal hernia. Equally a contralateral patent processus vaginalis was diagnosed and closed in 17.10%. There were no postoperative complications and we had a 0% postoperative hydrocele rate.Conclusion:Laparoscopic hernia repair is safe and carries all the benefits of minimally invasive surgery. We recommend that it is offered to patients and would like to refute previously claimed reports that it carries a higher reoccurrence rate or takes a long time to perform. Our reoccurrence rate of 0.17% is actually lower than many published reoccurrence rates after open repair.

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Risk factors for recurrence and contralateral inguinal hernia after laparoscopic percutaneous extraperitoneal closure for pediatric inguinal hernia

Cited by 39 publications

References 17 publications

The learning curve of laparoscopic percutaneous extraperitoneal closure (LPEC) for inguinal hernia: protocoled training in a single center for six pediatric surgical trainees

The learning curve of laparoscopic percutaneous extraperitoneal closure (LPEC) for inguinal hernia: protocoled training in a single center for six pediatric surgical trainees

Safety and efficacy of laparoscopic percutaneous extraperitoneal closure for inguinal hernia in infants younger than 6 months: A comparison with conventional open repair

Our Laparoscopic Surgical technique and experience in treating pediatric inguinal hernia over the past decade

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