Abstract
Introduction
We sought to retrospectively assess the operative findings and clinical outcomes of 148 girls who underwent laparoscopic inguinal hernia repair with the percutaneous internal ring suturing (PIRS) technique.
Methods
Between 2010 and 2014, girls with inguinal hernia underwent surgery using the laparoscopic PIRS technique described by Patkowski. Demographic and perioperative findings, complications, and recurrences were evaluated.
Results
A total of 205 inguinal hernia repairs were performed in 148 children with a mean age of 5.83 years (1 month–16 years). In 57 girls (38.5 %), the hernias were bilaterally repaired, while in 91 girls (61.5 %) hernias were unilaterally repaired. The mean follow-up time was 3.6 years (range 2.5–6.1 years). No serious complications or recurrence were noted. Granuloma occurred in one patient.
Conclusion
The PIRS technique is a safe, simple and effective procedure for girls. Excellent cosmetic results and reduced recurrence rates are associated with this method. This procedure is particularly suitable for girls because they lack a spermatic cord and vascular structures that can cause complications with this technique in boys. Based on our experience and others in the literature, we suggest that the PIRS procedure might be considered a gold standard for inguinal hernia operations in girls.
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References
Li C, Xu L, Peng Y, Liang X, Lin W (2015) Effects of single-port laparoscopic percutaneous extraperitoneal closure on the orientation of the vas deferens and testicular perfusion and volume: Experience from a single center. J Pediatr Urol. doi:10.1016/j.jpurol.2015.11.006
Bertozzi M, Marchesini L, Tesoro S, Appignani A (2015) Laparoscopic herniorrhaphy in children. Pediatr Med Chir 37(2):pmc.2015.109
Montupet P, Esposito C (2011) Fifteen years experience in laparoscopic inguinal hernia repair in pediatric patients. Results and considerations on a debated procedure. Surg Endosc 25:450–453
Patkowski D, Czernik J, Chrzan R (2006) Percutaneous internal ring suturing: a simple minimally invasive technique for inguinal hernia repair in children. J Laparoendosc Adv Surg Tech A 16:513–517
Shono T, Izaki T, Nakahori R, Yoshimaru K (2015) Testicular ascent after laparoscopic percutaneous extraperitoneal closure for inguinal hernias. Eur J Pediatr Surg 25:105–108
Xiang B, Jin S, Zhong L, Li F, Jiang X, Xu Z (2015) Reasons for recurrence after the laparoscopic repair of indirect inguinal hernia in children. J Laparoendosc Adv Surg Tech A. 25(8):681–683
Yildiz A, Çelebi S, Akin M et al (2012) Laparoscopic hernioraphy: a better approach for recurrent hernia in boys? Pediatr Surg Int 28:449–453
Wolak PK, Patkowski D (2014) Laparoscopic inguinal hernia repair in children using the percutaneous internal ring suturing technique—own experience. Wideochir Inne Tech Malo Inwazyjne 9:53–58
Karadag CA, Erginel B, Sever N et al (2015) Laparoscopic hernia repair in children: which method is the best? J Exp Clin Med 33(1):11–13
Montupet P, Esposito C (1999) Laparoscopic treatment of congenital inguinal hernia in children. J Pediatr Surg 34:420–423
Schier F (1998) Laparoscopic herniorrhaphy in girls. J Pediatr Surg 33:1495–1497
Li S, Li M, Wong KK, Liu L, Tam PK (2014) Laparoscopically assisted simple suturing obliteration (LASSO) of the internal ring using an epidural needle: a handy single-port laparoscopic herniorrhaphy in children. J Pediatr Surg 49:1818–1820
Yamoto M, Morotomi Y, Yamamoto M, Suehiro S (2011) Single-incision laparoscopic percutaneous extraperitoneal closure for inguinal hernia in children: an initial report. Surg Endosc 25:1531–1534
Takehara H, Yakabe S, Kameoka K (2006) Laparoscopic percutaneous extraperitoneal closure for inguinal hernia in children: clinical outcome of 972 repairs done in 3 pediatric surgical institutions. J Pediatr Surg 41:1999–2003
Patkowski D, Chrzan R, Jaworski W (2006) Percutaneous internal ring suturing for inguinal hernia repair in children under three months of age. Adv Clin Exp Med 15(5):851–856
Çelebi S, Yıldız A, Üçgül A et al (2012) Do open repair and different laparoscopic techniques in pediatric inguinal hernia repairs affect the vascularization of testes? J Pediatr Surg 47:1706–1710
Chan KL, Chan HY, Tam PK (2007) Towards a near-zero recurrence rate in laparoscopic inguinal hernia repair for pediatric patients of all ages. J Pediatr Surg 42:1993–1997
Toufique Ehsan M, Ng AT, Chung PH et al (2009) Laparoscopic hernioplasties in children: the implication on contralateral groin exploration for unilateral inguinal hernias. Pediatr Surg Int 25:759–762
Esposito C, Turial S, Alicchio F et al (2013) Laparoscopic repair of incarcerated inguinal hernia. A safe and effective procedure to adopt in children. Hernia 17:235–239
Thomas DT, Göcmen KB, Tulgar S, Boga I (2015) Percutaneous internal ring suturing is a safe and effective method for the minimal invasive treatment of pediatric inguinal hernia: experience with 250 cases. J Pediatr Surg 12:11
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Erginel, B., Akin, M., Yildiz, A. et al. Percutaneous internal ring suturing as a first choice laparoscopic inguinal hernia repair method in girls: a single-center study in 148 patients. Pediatr Surg Int 32, 697–700 (2016). https://doi.org/10.1007/s00383-016-3903-4
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DOI: https://doi.org/10.1007/s00383-016-3903-4