Shalaby technique for efficient single incision laparoscopic pediatric inguinal hernia repair

Shalaby, Rafik; Ismail, M.A.; Shehata, Sameh; Gamaan, Ibrahim; Yehya, Abdelaziz; Elsayaad, Ibrahim Mahmoud; Akl, Mabrouk; Shams, Abdelmonaem

doi:10.1016/j.jpedsurg.2015.07.019

Cited by 15 publications

(9 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, the conventional knot tying technique involves many manual steps that are difficult to repeat in subsequent knot tying. [11]. In this study, we innovated a simple technique for intracorporeal suturing using just needles rather than laparoscopic instrument.…”

Section: Discussionmentioning

confidence: 99%

“…The knot quality was assessed using the scale previously published by Muresan C. et al 2010 [8]. In this scale the knot quality is based on tightness, ability to hold, and adaptation of the edges of the peritoneum together with negative stress test [8,11].…”

Section: Patient and Methodsmentioning

confidence: 99%

“…While tightening of the knot, the distal hernia sac is being squeezed extracorporeally to expel CO2. The tightness of the sewing machine like sutures was tested as previously described by Shalaby et al [11]. Finally, after the knot has been tightened, the suture was cut flush with the anterior abdominal wall after pulling on both ends of the thread out of the abdomen.…”

Section: Instrumentationmentioning

confidence: 99%

See 2 more Smart Citations

Novel application of the sewing machine principle; a new simplified intracorporeal suturing technique for pediatric inguinal hernia

Shalaby

Abd-Alrazek

Hamed

et al. 2019

Journal of Pediatric Surgery

Self Cite

View full text Add to dashboard Cite

Background: The desire of pediatric surgeon to reduce incision related morbidity and pain while achieving good cosmetic results has recently led to the introduction of single incision pediatric endosurgery [SIPES] and needlescopic surgery. Intracorporeal suturing and knot tying during SIPES remain challenging. The aim of this study is to introduce a novel and simple technique for intracorporeal suturing of the pediatric inguinal hernia after needlescopic disconnection of hernia sac using just needles rather than laparoscopic instruments. It is an imitation of the principles of sewing machine. Methods: The first author discussed the idea of the technique with the coauthors and a demonstration was done on a Silicon Pad before application of the technique on children with congenital inguinal hernia [CIH] for peritoneum closure after needlescopic disconnection of the hernia sac. The main outcome measures were feasibility of the technique, suturing and knotting time and recurrence rate. Results: The sutures were snugly applied to the ridges of Silicon Pad with good approximation and the knot was firmly tightened in all experiments. After applying and mastering the technique on a Silicon Pad, we shifted to use it on 373 children with 491 hernia defects. All operations were completed by the needlescopic technique without the need for insertion of any laparoscopic instruments. The time required for suturing of the peritoneum around internal inguinal ring [IIR] and knot tying, decreased considerably from 6 min 27 s in the first operation to less than 4 min after the fifth operation and stabilized at approximately 4 min 30 s. No major intraoperative complication. There was no recurrence during a mean follow-up period of 19.6 ± 1.2 months. Conclusion: The closure of the peritoneum around the IIR using needles mimicking what is happening in sewing machine suturing is a feasible, safe and effective line of treatment of children with CIH. The cosmetic results are 42 outstanding without any recurrence.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Patient and Methodsmentioning

confidence: 99%

Section: Instrumentationmentioning

confidence: 99%

See 1 more Smart Citation

Novel application of the sewing machine principle; a new simplified intracorporeal suturing technique for pediatric inguinal hernia

Shalaby

Abd-Alrazek

Hamed

et al. 2019

Journal of Pediatric Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

“…Also, inclusions of subcutaneous tissues within the suture may cause postoperative paresthesia or inguinal pain [ 15 – 19 ]. On the other hand, intracorporeal suture knotting during SIPC is challenging, due to bad ergonomics caused by limited access and movement space that required higher experience, certain skills level, long learning curve, and undutiful and it is a time consuming step [ 20 – 24 ].…”

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

View full text Add to dashboard Cite

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.

show abstract

“…Shalaby et al [30] published a description of 150 patients treated with SILHR, and reported one case of recurrence and three cases of hydrocele. 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.…”

Section: -26]mentioning

confidence: 99%

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

Helal¹

2017

MIS

View full text Add to dashboard Cite

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:

show abstract

Shalaby technique for efficient single incision laparoscopic pediatric inguinal hernia repair

Cited by 15 publications

References 14 publications

Novel application of the sewing machine principle; a new simplified intracorporeal suturing technique for pediatric inguinal hernia

Novel application of the sewing machine principle; a new simplified intracorporeal suturing technique for pediatric inguinal hernia

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

Contact Info

Product

Resources

About