Ten-year review of groin laparoscopy in 1001 pediatric patients with clinical unilateral inguinal hernia: an improved technique with transhernia multiple-channel scope

Saad, Saad; Mansson, Jonas; Saad, Adam; Goldfarb, Michael A.

doi:10.1016/j.jpedsurg.2010.12.020

Cited by 32 publications

(18 citation statements)

References 13 publications

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“…Previous reports stated that laparoscopic contralateral internal inguinal ring observation was attempted from the early 1990s [25]. A contralateral PPV was seen in 6-66 % of cases [16,[25][26][27][28][29][30][31][32]; the range is very wide. This seems to be because the way of observing the contralateral internal ring varied in each study.…”

Section: Discussionmentioning

confidence: 99%

Comparison of percutaneous extraperitoneal closure (LPEC) and open repair for pediatric inguinal hernia: experience of a single institution with over 1000 cases

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Comparison of percutaneous extraperitoneal closure (LPEC) and open repair for pediatric inguinal hernia: experience of a single institution with over 1000 cases

et al. 2015

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“…Also laparoscopic inspection of the contralateral internal ring has been proven an effective technique to avoid unnecessary open exploration in patients with elevated risk of contralateral patent processus unidentified on clinical exam. With laparoscopic exploration (multichannel scope through ipsilateral open hernia sac), patency of the contralateral groin has been documented in 23 and 43 % in patients \1 year old [2].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic needle-assisted inguinal hernia repair in 495 children

et al. 2014

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Minimally invasive surgery for inguinal hernia repair in children has been a controversial topic for pediatric surgeons. Our method for inguinal hernia repair using laparoscopic techniques has comparable outcomes to the standard open technique. We describe our technique and experience with the laparoscopic needle-assisted repair of inguinal hernia (LNAR). We report 502 cases (710 hernias) from 2009 to 2013 by 3 surgeons. We reviewed our prospectively collected outcomes database of all patients receiving LNAR from 1/2009 to 3/2013. 502 cases in 495 patients <13 years old with 710 inguinal hernias were identified for analysis and review. Hernia repair is accomplished with a single-port needle-assisted technique. After identification of a patent processus vaginalis, the internal ring is encircled in an extraperitoneal plane using a 22G-Touhy needle for placement of a purse-string suture, tied extracorporally, and buried beneath the skin. The technique was standardized for all cases. 710 inguinal hernias were laparoscopically repaired in 495 patients (408 boys and 87 girls) age range 11 days to 12.8 years (mean 29.2 months; median 15.5 months). 294 patients had unilateral repair (199R and 95L) and 208 had bilateral repair. Mean operating time for unilateral was 20.5 min, and bilateral was 26.4 min. 21 minor complications were identified (9 superficial wound infections, 8 suture granulomas, and 4 recurrent hydroceles) and 4 recurrences. Mean time since surgery is 30 months (3-54 months). Mean follow-up was 10.7 months (0.3-38.4 months). Post-operative data show our technique is safe with a 4 % rate of minor complication. Recurrence rate was 0.56 % for the total number of hernias (4/710). This recurrence rate is comparable and in many cases less than open technique. Furthermore, laparoscopy objectively identifies asymptomatic or occult contralateral defect, uses a smaller incision, and eliminates dissection of the cord structures potentially reducing the risk of cord injury.

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“…Reported rates of contralateral PPV decrease to between 33% and 50% in children younger than 1 year of age and are as low as 15% by 5 years of age. [12][13][14][15][16] Not all cases of PPV result in inguinal hernias. The estimated childhood risk of developing an inguinal hernia if there is a PPV is between 25% and 50%.…”

Section: Embryology and Natural History Of The Patent Processus Vaginmentioning

confidence: 99%

Assessment and Management of Inguinal Hernia in Infants

Wang¹,

Papile²,

Baley³

et al. 2012

Pediatrics

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Inguinal hernia repair in infants is a routine surgical procedure. However, numerous issues, including timing of the repair, the need to explore the contralateral groin, use of laparoscopy, and anesthetic approach, remain unsettled. Given the lack of compelling data, consideration should be given to large, prospective, randomized controlled trials to determine best practices for the management of inguinal hernias in infants.

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Ten-year review of groin laparoscopy in 1001 pediatric patients with clinical unilateral inguinal hernia: an improved technique with transhernia multiple-channel scope

Cited by 32 publications

References 13 publications

Comparison of percutaneous extraperitoneal closure (LPEC) and open repair for pediatric inguinal hernia: experience of a single institution with over 1000 cases

Comparison of percutaneous extraperitoneal closure (LPEC) and open repair for pediatric inguinal hernia: experience of a single institution with over 1000 cases

Laparoscopic needle-assisted inguinal hernia repair in 495 children

Assessment and Management of Inguinal Hernia in Infants

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