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

Abstract

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:

Inguinal Hernia in Infancy and Children

“…We think that there would be no reason to perform multiple incisions in laparoscopic hernia repair in children as SILHR is a safe and secure technique with excellent cosmetic results because it results in single umbilical wound which is already scar area in the body, the scar is hidden in the fold of the umbilicus, and the puncture wounds from the epidural needle are practically unnoticeable. Finally, SILHR in children is safe, perhaps even less technically demanded than open herniotomy [35][36][37]. Inguinal Hernia in Infancy and Children http://dx.doi.org/10.5772/intechopen.69378…”