Without hydrodissection for single-port laparoscopic percutaneous extraperitoneal internal ring closure using an inner grappler in the treatment of inguinal hernia in children
LIU Xue-lai ZHANG Yong-ting LI Suo-lin
(1.Department of Surgery, Children's Hospital Capital Institute of Pediatric, Beijing 100020, China; 2. Department of Pediagric Surgery, The Second Hospital of Hebei Medical University Hebei, Shijiazhuang 050000, China
Abstract: 【Abstract】 Objective To explore the safety, availability and feasibility of single-port laparoscopic percutaneous extraperitoneal internal ring closure using an inner grappler without hydrodissection for inguinal hernia in children. Methods From December 2017 to April 2018, 32 children with inguinal hernias in Department of Pediagric Surgery of The Second Hospital of Hebei Medical University were undertook single-port laparoscopic percutaneous extraperitoneal internal ring closure using an inner grappler without hydrodissection. Under visualization of single-port laparoscopic, an inner grappler with a non-absorbable suture was inserted at abdominal transverse striation to extraperitoneal space. The inclined surface of an inner grappler with suture was out of the operator's vision and reached back
retroperitoneum and passed through the space between the vas deferens and the retroperitoneum
and kept in abdominal cavity from the dangerous triangle. The same technique was utilized to pass
through spermatic vessel on outside of hernia, followed by ligation and close the orifice of inner
hernia. The basic and surgical conditions of the children were analyzed retrospectively. All of the
cases were followed up for 6-10 months after operation and whose postoperative recurrence rate and
complications were analyzed. Results Age of all patients ranged from 12 months to 2 years and 6 months (27 males, 5 females). Among of the cases, 25 cases were diagnosed as unilateral inguinal hernia, 7 cases were diagnosed as bilateral inguinal hernias pre-operation. While 21 cases were diagnosed as unilateral inguinal hernia, 11 cases were diagnosed as bilateral inguinal hernias during operation. A total of 43 cases were successfully completed using single-port laparoscopic percutaneous extraperitoneal internal ring closure using an inner grappler without hydrodissection technique. Mean operating time for unilateral and bilateral inguinal hernia was (8.2±1.6 )min and（16.5±1.5）min. Follow-up for 6-10 months after operation, there were no wound infections, iatrogenic cryptorchidism or testicular atrophy and other complications, as well as recurrence hernia, hydrocele, and suture granuloma formations. Conclusions It is safe and convenient to apply the single-port laparoscopic percutaneous extraperitoneal internal ring closure using an inner grappler without hydrodissection technique for the children with inguinal hernia. The result of the operation is satisfactory.
刘雪来 张永婷 李索林. 免水分离改良钩针辅助单孔腹腔镜内环腹膜外闭合治疗儿童腹股沟斜疝[J]. 发育医学电子杂志, 2019, 7(2): 141-145.
LIU Xue-lai ZHANG Yong-ting LI Suo-lin. Without hydrodissection for single-port laparoscopic percutaneous extraperitoneal internal ring closure using an inner grappler in the treatment of inguinal hernia in children. Journal of Developmental Medicine(Electronic Version), 2019, 7(2): 141-145.
2019, Vol. 7 
