BACKGROUND: Laparoscopy is an alternative procedure for pediatric inguinal hernia; however, reported techniques necessitate two or three trocars and excellent intra-abdominal skills. This study was designed to describe and evaluate the preliminary result of one-trocar laparoscopic-assisted transperitoneal closure for inguinal hernia in children. METHODS: A total of 33 children with inguinal hernia (body weight range, 2270 g to 58 kg) were included in this study from March to November 2007. Under a 5-mm laparoscopic guidance, the hernia defect was enclosed by a nonabsorbable suture, which was introduced into the abdomen by an 18-gauge vascular access on one side of the hernia defect and withdrawn on the opposite side by a homemade hook-pin through a needle puncture wound. Then, extracorporeal knot tying was performed. RESULTS: A total of 52 procedures were performed, and the mean operating time was 46.2 +/- 16.2 (range, 18-87) minutes. No cauterization was used during the operations and there was no serious operative morbidity. The mean follow-up period was 7.6 +/- 2.5 (range, 4-12) months. No recurrence was observed during this period. CONCLUSIONS: This easy technique provides the benefits of laparoscopic herniorrhaphy and combines the advantages derived from the novel use of a hook-pin and vascular access simplicity, low cost, safety, minimized tissue trauma, and improved cosmetics. In addition, only one umbilical trocar wound and another needle puncture point were made. Therefore, this procedure is recommended for pediatric inguinal hernia.
BACKGROUND: Laparoscopy is an alternative procedure for pediatric inguinal hernia; however, reported techniques necessitate two or three trocars and excellent intra-abdominal skills. This study was designed to describe and evaluate the preliminary result of one-trocar laparoscopic-assisted transperitoneal closure for inguinal hernia in children. METHODS: A total of 33 children with inguinal hernia (body weight range, 2270 g to 58 kg) were included in this study from March to November 2007. Under a 5-mm laparoscopic guidance, the hernia defect was enclosed by a nonabsorbable suture, which was introduced into the abdomen by an 18-gauge vascular access on one side of the hernia defect and withdrawn on the opposite side by a homemade hook-pin through a needle puncture wound. Then, extracorporeal knot tying was performed. RESULTS: A total of 52 procedures were performed, and the mean operating time was 46.2 +/- 16.2 (range, 18-87) minutes. No cauterization was used during the operations and there was no serious operative morbidity. The mean follow-up period was 7.6 +/- 2.5 (range, 4-12) months. No recurrence was observed during this period. CONCLUSIONS: This easy technique provides the benefits of laparoscopic herniorrhaphy and combines the advantages derived from the novel use of a hook-pin and vascular access simplicity, low cost, safety, minimized tissue trauma, and improved cosmetics. In addition, only one umbilical trocar wound and another needle puncture point were made. Therefore, this procedure is recommended for pediatric inguinal hernia.
Authors: Monika E Hagen; Oliver J Wagner; Kari Thompson; Garth Jacobsen; Adam Spivack; Brian Wong; Mark Talamini; Santiago Horgan Journal: J Gastrointest Surg Date: 2009-11-12 Impact factor: 3.452