A prospective study to assess the feasibility of single port laparoscopic needle assisted repair of pediatric inguinal hernias

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Juveria Iman Suhitha Gajanthody Ashraf Ahmed Gagan Deep P.S.M Ameer Ali Harishchandra B

Abstract

Background: Congenital inguinal hernias are very common paediatric surgical conditions with incidence of 0.8 – 4.4% in children and up to 30% in preterm babies, which occur due to the failure of closure of the processus vaginalis. While the gold standard treatment remains to be open herniotomy, in the last two decades minimally invasive surgeries have revolutionized the hernia surgery and have evolved from 3 port to single port, intracorporeal knotting to extracorporeal knotting and 5 mm camera port to 3 mm camera port with multiple benefits.


Methodology: This is a prospective study conducted at a single tertiary care centre over 1 year. All the patients admitted under the Department of Paediatric Surgery, with a clinical and/or radiological diagnosis of inguinal hernia and planned for single port laparoscopic needle assisted repair were included in the study. Data was collected in terms of intra operative finding, duration of procedure, complications, pain and post operative hospital stay.


Results: A total of 40 patients were included in the study with a male predominance. Clinically majority were right inguinal hernia which was reducible. Intraoperatively, 7 cases of bilateral hernia were identified which were not detected pre operatively. 2 patients who underwent this procedure had complications and majority of the patients had mild pain.


Conclusion: Single port laparoscopic herniotomy is at par with gold standard open herniotomy in the paediatric population. This procedure has better cosmesis, lesser post operative pain, hospital stay and most importantly it could identify occult hernias.

Keywords: feasibility of single port laparoscopic needle assisted repair of pediatric inguinal hernias

Article Details

How to Cite
IMAN, Juveria et al. A prospective study to assess the feasibility of single port laparoscopic needle assisted repair of pediatric inguinal hernias. Medical Research Archives, [S.l.], v. 12, n. 2, feb. 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5002>. Date accessed: 27 apr. 2024. doi: https://doi.org/10.18103/mra.v12i2.5002.
Section
Research Articles

References

1. Kumar A, Ramakrishnan TS. Single port laparoscopic repair of paediatric inguinal hernias: Our experience at a secondary care centre. Journal of Minimal Access Surgery. 2013;9(1):7. doi:10.4103/0972-9941.107126

2. Bharathi RS, Dabas AK, Arora M, Baskaran V. Laparoscopic ligation of internal ring—three ports versus single-port technique: are working ports necessary?. Journal of Laparoendoscopic & Advanced Surgical Techniques. 2008 Dec 1;18(6):891-4.

3. Ali M, Rashi R, Sinha A, Kumar A, Kumar B. Paediatric Laparoscopic Inguinal Hernia Repair: Level of Disconnection of Peritoneal Cuff – An Observational Study. African Journal of Paediatric Surgery. 2023;20(3):202-205. doi:10.4103/ajps.ajps_98_21

4. Rajbhandari N, Karki B, Guglielmetti LC, Vuille-dit-Bille RN. Establishment of Single-Port, Laparoscopic, Pediatric Hernia Repair in a Developing Country. Journal of Laparoendoscopic & Advanced Surgical Techniques. 2021; 31(1):124-129. doi: https://doi.org/10.1089/lap.2020.0547

5. Amano H, Tanaka Y, Kawashima H, et al. Comparison of single-incision laparoscopic percutaneous extraperitoneal closure (SILPEC) and open repair for pediatric inguinal hernia: a single-center retrospective cohort study of 2028 cases. Surgical Endoscopy. 2017; 31(12):4988-4995. doi: https://doi.org/10.1007/s00464-017-5472-6

6. Shalaby R, Elsayaad I, Alsamahy O, et al. One trocar needlescopic assisted inguinal hernia repair in children: a novel technique. Journal of Pediatric Surgery. 2018;53(1):192-198. doi: https://doi.org/10.1016/j.jpedsurg.2017.08.020

7. Chang YT, Lin JY, Lee JY, Tsai CJ, Chiu WC, Chiu CS. Comparative Mid-term Results Between Inguinal Herniotomy and Single-port Laparoscopic Herniorrhaphy for Pediatric Inguinal Hernia. Surgical Laparoscopy, Endoscopy & Percutaneous Techniques. 2012;22(6):526-531. doi: https://doi.org/10.1097/sle.0b013e3182680842

8. Wang KS. Assessment and Management of Inguinal Hernia in Infants. PEDIATRICS. 2012;130(4):768-773. doi: https://doi.org/10.1542/peds.2012-2008

9. Pogorelić Z. Advances and Future Challenges of Minimally Invasive Surgery in Children. Children. 2022; 9(12):1959. https://doi.org/10.3390/children9121959

10. Schier F, Montupet P, Esposito C. Laparoscopic inguinal herniorrhaphy in children: A three-center experience with 933 repairs. Journal of Pediatric Surgery. 2002;37(3):395-397. doi: https://doi.org/10.1053/jpsu.2002.30842

11. Schier F, Danzer E, Bondartschuk M. Incidence of contralateral patent processus vaginalis in children with inguinal hernia. Journal of Pediatric Surgery. 2001;36(10):1561-1563. doi: https://doi.org/10.1053/jpsu.2001.27049

12. Yuk Him Tam, Yin Cheong Wong, Kit K, et al. Unexpected Metachronous Hernia Development in Children Following Laparoscopic Unilateral Hernia Repair with Negative Evaluation for Contralateral Patent Processus Vaginalis. Journal of Laparoendoscopic & Advanced Surgical Techniques. 2013;23(3):287-290. doi: https://doi.org/10.1089/lap.2012.0365

13. Shalaby RY, Fawy M, Soliman SM, Dorgham A. A new simplified technique for needlescopic inguinal herniorrhaphy in children. Journal of Pediatric Surgery. 2006;41(4):863-867. doi: https://doi.org/10.1016/j.jpedsurg.2005.12.042

14. Ozgediz D, Roayaie K, Lee H, et al. Subcutaneous endoscopically assisted ligation (SEAL) of the internal ring for repair of inguinal hernias in children: report of a new technique and early results. Surgical Endoscopy. 2007;21(8):1327-1331. doi: https://doi.org/10.1007/s00464-007-9202-3

15. Chan KL. Laparoscopic repair of recurrent childhood inguinal hernias after open herniotomy. Hernia. 2006;11(1):37-40. doi: https://doi.org/10.1007/s10029-006-0158-3

16. Miyake H, Fukumoto K, Yamoto M, et al. Comparison of percutaneous extraperitoneal closure (LPEC) and open repair for pediatric inguinal hernia: experience of a single institution with over 1000 cases. Surg Endosc. 2016;30(4):1466-1472. doi:10.1007/s00464-015-4354-z.