Original Article

J Minim Invasive Surg 2014; 17(4): 71-74

Published online December 15, 2014

https://doi.org/10.7602/jmis.2014.17.4.71

© The Korean Society of Endo-Laparoscopic & Robotic Surgery

소아 서혜부 탈장 환자에서 복강경을 이용한 탈장낭의 고위 결찰 수술

이도영ㆍ최원용

동국대학교 일산병원 외과학교실

Received: September 1, 2014; Revised: October 13, 2014; Accepted: October 13, 2014

Laparoscopic High Ligation of Hernia Sac of Inguinal Hernia in Pediatric Patients

Do Young Lee, M.D., Won Yong Choi, M.D.

Department of Surgery, Dongguk University Ilsan Hospital, Goyang, Korea

Received: September 1, 2014; Revised: October 13, 2014; Accepted: October 13, 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Purpose: Although laparoscopic surgery in children has expanded in recent years. laparoscopic hernia repair in children is still debatable. We aimed to summarize and describe our results of laparoscopic inguinal hernia repair and techniques among children. Methods: Between March 2011 and August 2013, 117 children (81 male, 36 female) underwent laparoscopic inguinal hernia repair at the department of surgery. The clinical out-comes were collected retrospectively. Results: The mean follow-up period was 26.2 months. Thirteen patients were ex-premature infants and a contralateral patent processus vaginalis (PPV) was present in 44 of the 110 unilateral inguinal hernia patients. There were two postoperative complications (transient hydrocele, umbilical port site infection). The mean operative time was 47 minutes. Recurrence, metachronous hernia, and testicular atrophy were not observed during the follow-up period. Conclusion: Our preliminary experiences suggest that the laparoscopic purse-string suture of internal inguinal opening of the hernia sac could be an effective and reliable alternative for management of pediatric inguinal hernia.

Keywords Laparoscopic surgery, Purse-string suture, Inguinal hernia, Children

  1. Wang KS. Assessment and management of inguinal hernia in infants. Pediatrics 2012;130:768-773.
    Pubmed CrossRef
  2. Chan Kl, Hui WC, Tam PK. Prospective randomized singlecenter, single-blind comparison of laparoscopic vs open repair of pediatric inguinal hernia. Surg Endosc 2005;19:927-932.
    Pubmed CrossRef
  3. Schier F. Laparoscopic inguinal hernia repair-a prospective personal series of 542 children. J Pediatr Surg 2006;41:10811084.
    Pubmed CrossRef
  4. Boo Yj, Han HJ, Ji WB, et al. Laparoscopic hernia sac transection and intracorporeal ligation show very low recurrence rate in pediatric inguinal hernia. J Laparoendosc Adv Surg Tech A 2012;22:720-723.
    Pubmed CrossRef
  5. Abraham Mk, Nasir AA, Puzhankara R, et al. Laparoscopic inguinal hernia repair in children: a single-centre experience over 7 years. Afr J Paediatr Surg 2012;9:137-139.
    Pubmed CrossRef
  6. Chang YT, Lin JY, Lee JY, et al. Comparative mid-term results between inguinal herniotomy and single-port laparoscopic herniorrhaphy for pediatric inguinal hernia. Surg Laparosc Endosc Percutan Tech 2012;22:526-531.
    Pubmed CrossRef
  7. GunerYs, Emami CN, Chokshi NK, et al. Inversion herniotomy:a laparoscopic technique for female inguinal hernia repair. J Laparoendosc Adv Surg Tech A 2010;20:481-484.
    Pubmed CrossRef
  8. Molina Vazquez ME, Sanchez Abuin A, Aguilar Cuesta R. Laparoscopic assisted percutaneous treatment of inguinal hernia in infants. Cir Pediatr 2012;25:4-8.
    Pubmed
  9. Schier F. Laparoscopic herniorrhaphy in girls. J Pediatr Surg 1998;33:1495-1497.
    CrossRef
  10. Marte A, Sabatino MD, Borrelli M, et al. Decreased recurrence rate in the laparoscopic herniorraphy in children:comparison between two techniques. J Laparoendosc Adv Surg Tech A 2009;19:259-252.
    Pubmed CrossRef
  11. Yip KF, Tam PK, Li MK. Laparoscopic flip-flap hernioplasty:an innovative technique for pediatric hernia surgery. Surg Endosc 2004;18:1126-1129.
    Pubmed CrossRef
  12. Harrison MR, Lee H, Albanese CT, et al. Subcutaneous endoscopically assisted ligation (SEAL) of the internal ring for repair of inguinal hernias in children: a novel technique. J Pediatr Surg 2005;40:1177-1180.
    Pubmed CrossRef
  13. Puri P, Guiney EJ, O'Donnell B. Inguinal hernia in infants:the fate of the testis following incarceration. J Pediatr Surg 1984;19:44-46.
    CrossRef
  14. Rescorla FJ, Grosfeld JL. Inguinal hernia repair in the perinatal period and early infancy: clinical considerations. J Pediatr Surg 1984;19:832-837.
    CrossRef
  15. Janetschek G, Reissigl A, Bartsch G. Laparoscopic repair of pediatric hydroceles. J Endourol 1994;8:415-417.
    Pubmed CrossRef
  16. Rowe MI, Copelson LW, Clatworthy HW. The patent processusvaginalis and the inguinal hernia. J Pediatr Surg 1969;4:102-107.
    CrossRef
  17. Holcomb Gw 3rd, Morgan WM, Brock JW, et al. Laparoscopic evaluation for contralateral patent processusvaginalis:Part II. J Pediatr Surg 1996;31:1170-1173.
    CrossRef
  18. Geisler DP, Jegathesan S, Parmley MC, et al. Laparoscopic exploration for the clinically undetected hernia in infancy and childhood. Am J Surg 2001;182:693-696.
    CrossRef
  19. McGregor DB, Halverson K, McVay CB. The unilateral pediatric inguinal hernia: Should the contralateral side by explored? J Pediatr Surg 1980;15:313-317.
    CrossRef
  20. EinSh, Njere I, Ein A. Six thousand three hundred sixty-one pediatric inguinal hernias: a 35-year review. J Pediatr Surg 2006;41:980-986.
    Pubmed CrossRef
  21. Zendejas B, Zarroug AE, Erben YM, et al. Impact of childhood inguinal hernia repair in adulthood: 50 years of follow-up. J Am Coll Surg 2010;211:762-768.
    Pubmed CrossRef
  22. Gilbert M, Clatworthy HW, Jr., Bilateral operations for inguinal hernia and hydrocele in infancy and childhood. Am J Surg 1959;97:255-259.
    CrossRef
  23. Koivusalo AI, Korpela R, Wirtavuori K, et al. A singleblinded, randomized comparison of laparoscopic versus open hernia repair in children. Pediatrics 2009;123:332-337.
    Pubmed CrossRef
  24. Yang C, Zhang H, Pu J, et al. Laparoscopic vs open herniorrhaphy in the management of pediatric inguinal hernia: a systemic review and meta-analysis. J Pediatr Surg 2011;46:1824-1834.
    Pubmed CrossRef
  25. Dutta S, Albanese C. Transcutaneous laparoscopic hernia repair in children: a prospective review of 275 hernia repairs with minimum 2-year follow-up. Surg Endosc 2009;23:103107.
    Pubmed CrossRef
  26. Schier F, Montupet P, Esposito C. Laparoscopic inguinal herniorrhaphy in children: a three-center experience with 933 repairs. J Pediatr Surg 2002;37:395-397.
    Pubmed CrossRef
  27. Phelps S, Agrawal M. Morbidity after neonatal inguinal herniotomy. J Pediatr Surg 1997;32:445-447.
    CrossRef
  28. Nagraj S, Sinha S, Grant H, et al. The incidence of complications following primary inguinal herniotomy in babies weighing 5 kg or less. Pediatr SurgInt 2006;22:500-502.
    CrossRef

Article

Original Article

J Minim Invasive Surg 2014; 17(4): 71-74

Published online December 15, 2014 https://doi.org/10.7602/jmis.2014.17.4.71

Copyright © The Korean Society of Endo-Laparoscopic & Robotic Surgery.

소아 서혜부 탈장 환자에서 복강경을 이용한 탈장낭의 고위 결찰 수술

이도영ㆍ최원용

동국대학교 일산병원 외과학교실

Received: September 1, 2014; Revised: October 13, 2014; Accepted: October 13, 2014

Laparoscopic High Ligation of Hernia Sac of Inguinal Hernia in Pediatric Patients

Do Young Lee, M.D., Won Yong Choi, M.D.

Department of Surgery, Dongguk University Ilsan Hospital, Goyang, Korea

Received: September 1, 2014; Revised: October 13, 2014; Accepted: October 13, 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose: Although laparoscopic surgery in children has expanded in recent years. laparoscopic hernia repair in children is still debatable. We aimed to summarize and describe our results of laparoscopic inguinal hernia repair and techniques among children. Methods: Between March 2011 and August 2013, 117 children (81 male, 36 female) underwent laparoscopic inguinal hernia repair at the department of surgery. The clinical out-comes were collected retrospectively. Results: The mean follow-up period was 26.2 months. Thirteen patients were ex-premature infants and a contralateral patent processus vaginalis (PPV) was present in 44 of the 110 unilateral inguinal hernia patients. There were two postoperative complications (transient hydrocele, umbilical port site infection). The mean operative time was 47 minutes. Recurrence, metachronous hernia, and testicular atrophy were not observed during the follow-up period. Conclusion: Our preliminary experiences suggest that the laparoscopic purse-string suture of internal inguinal opening of the hernia sac could be an effective and reliable alternative for management of pediatric inguinal hernia.

Keywords: Laparoscopic surgery, Purse-string suture, Inguinal hernia, Children

References

  1. Wang KS. Assessment and management of inguinal hernia in infants. Pediatrics 2012;130:768-773.
    Pubmed CrossRef
  2. Chan Kl, Hui WC, Tam PK. Prospective randomized singlecenter, single-blind comparison of laparoscopic vs open repair of pediatric inguinal hernia. Surg Endosc 2005;19:927-932.
    Pubmed CrossRef
  3. Schier F. Laparoscopic inguinal hernia repair-a prospective personal series of 542 children. J Pediatr Surg 2006;41:10811084.
    Pubmed CrossRef
  4. Boo Yj, Han HJ, Ji WB, et al. Laparoscopic hernia sac transection and intracorporeal ligation show very low recurrence rate in pediatric inguinal hernia. J Laparoendosc Adv Surg Tech A 2012;22:720-723.
    Pubmed CrossRef
  5. Abraham Mk, Nasir AA, Puzhankara R, et al. Laparoscopic inguinal hernia repair in children: a single-centre experience over 7 years. Afr J Paediatr Surg 2012;9:137-139.
    Pubmed CrossRef
  6. Chang YT, Lin JY, Lee JY, et al. Comparative mid-term results between inguinal herniotomy and single-port laparoscopic herniorrhaphy for pediatric inguinal hernia. Surg Laparosc Endosc Percutan Tech 2012;22:526-531.
    Pubmed CrossRef
  7. GunerYs, Emami CN, Chokshi NK, et al. Inversion herniotomy:a laparoscopic technique for female inguinal hernia repair. J Laparoendosc Adv Surg Tech A 2010;20:481-484.
    Pubmed CrossRef
  8. Molina Vazquez ME, Sanchez Abuin A, Aguilar Cuesta R. Laparoscopic assisted percutaneous treatment of inguinal hernia in infants. Cir Pediatr 2012;25:4-8.
    Pubmed
  9. Schier F. Laparoscopic herniorrhaphy in girls. J Pediatr Surg 1998;33:1495-1497.
    CrossRef
  10. Marte A, Sabatino MD, Borrelli M, et al. Decreased recurrence rate in the laparoscopic herniorraphy in children:comparison between two techniques. J Laparoendosc Adv Surg Tech A 2009;19:259-252.
    Pubmed CrossRef
  11. Yip KF, Tam PK, Li MK. Laparoscopic flip-flap hernioplasty:an innovative technique for pediatric hernia surgery. Surg Endosc 2004;18:1126-1129.
    Pubmed CrossRef
  12. Harrison MR, Lee H, Albanese CT, et al. Subcutaneous endoscopically assisted ligation (SEAL) of the internal ring for repair of inguinal hernias in children: a novel technique. J Pediatr Surg 2005;40:1177-1180.
    Pubmed CrossRef
  13. Puri P, Guiney EJ, O'Donnell B. Inguinal hernia in infants:the fate of the testis following incarceration. J Pediatr Surg 1984;19:44-46.
    CrossRef
  14. Rescorla FJ, Grosfeld JL. Inguinal hernia repair in the perinatal period and early infancy: clinical considerations. J Pediatr Surg 1984;19:832-837.
    CrossRef
  15. Janetschek G, Reissigl A, Bartsch G. Laparoscopic repair of pediatric hydroceles. J Endourol 1994;8:415-417.
    Pubmed CrossRef
  16. Rowe MI, Copelson LW, Clatworthy HW. The patent processusvaginalis and the inguinal hernia. J Pediatr Surg 1969;4:102-107.
    CrossRef
  17. Holcomb Gw 3rd, Morgan WM, Brock JW, et al. Laparoscopic evaluation for contralateral patent processusvaginalis:Part II. J Pediatr Surg 1996;31:1170-1173.
    CrossRef
  18. Geisler DP, Jegathesan S, Parmley MC, et al. Laparoscopic exploration for the clinically undetected hernia in infancy and childhood. Am J Surg 2001;182:693-696.
    CrossRef
  19. McGregor DB, Halverson K, McVay CB. The unilateral pediatric inguinal hernia: Should the contralateral side by explored? J Pediatr Surg 1980;15:313-317.
    CrossRef
  20. EinSh, Njere I, Ein A. Six thousand three hundred sixty-one pediatric inguinal hernias: a 35-year review. J Pediatr Surg 2006;41:980-986.
    Pubmed CrossRef
  21. Zendejas B, Zarroug AE, Erben YM, et al. Impact of childhood inguinal hernia repair in adulthood: 50 years of follow-up. J Am Coll Surg 2010;211:762-768.
    Pubmed CrossRef
  22. Gilbert M, Clatworthy HW, Jr., Bilateral operations for inguinal hernia and hydrocele in infancy and childhood. Am J Surg 1959;97:255-259.
    CrossRef
  23. Koivusalo AI, Korpela R, Wirtavuori K, et al. A singleblinded, randomized comparison of laparoscopic versus open hernia repair in children. Pediatrics 2009;123:332-337.
    Pubmed CrossRef
  24. Yang C, Zhang H, Pu J, et al. Laparoscopic vs open herniorrhaphy in the management of pediatric inguinal hernia: a systemic review and meta-analysis. J Pediatr Surg 2011;46:1824-1834.
    Pubmed CrossRef
  25. Dutta S, Albanese C. Transcutaneous laparoscopic hernia repair in children: a prospective review of 275 hernia repairs with minimum 2-year follow-up. Surg Endosc 2009;23:103107.
    Pubmed CrossRef
  26. Schier F, Montupet P, Esposito C. Laparoscopic inguinal herniorrhaphy in children: a three-center experience with 933 repairs. J Pediatr Surg 2002;37:395-397.
    Pubmed CrossRef
  27. Phelps S, Agrawal M. Morbidity after neonatal inguinal herniotomy. J Pediatr Surg 1997;32:445-447.
    CrossRef
  28. Nagraj S, Sinha S, Grant H, et al. The incidence of complications following primary inguinal herniotomy in babies weighing 5 kg or less. Pediatr SurgInt 2006;22:500-502.
    CrossRef

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