Journal of Developmental Medicine(Electronic Version)  2019, Vol. 7 Issue (3): 203-207 DOI: 10.3969/j.issn.2095-5340.2019.03.008 |
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| Application for extraperitoneal closure of using an inner grappler in the operation of inguinal hernia in children |
| LIU Xue-lai, LI Long, LI Suo-lin, CAO Xue-hui , ZHANG Yong-ting , LIU Lin, LI Liang-xing
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| 1. Children's Hospital Capital Institute of Pediatric 2.The Second Hospital of Hebei Medical University |
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Abstract 【Abstract】 Objective To introduce the way for using disposable extraperitoneal closure of using an inner grappler in hernia ring ligation and evaluate its feasibility and recent efficacy. Methods From November 2017 to January 2018, 26 children with inguinal hernias were underwent single-port laparoscopic percutaneous extraperitoneal closure（SPLPEC）using an inner grappler with hernia ring ligation in Department of Pediatric Surgery of The Second Hospital of Hebei Medical University. Under
laparoscopic visualization through a single umbilical port, an inner grappler with a nonabsorbable suture was introduced into extraperitoneal space at the corresponding point of the internal inguinal ring, which could be readily kept in an identical subcutaneous path. The internal ring orifice was absolutely lassoed extraperitoneally by the suture without peritoneal punctures and withdrawn on the opposite side using the cannula around the internal ring with the hydrodissection technique. The basic information of theinfants, operating time, recurrent rate of post-operative and complications were analyzed retrospectively
for evaluation the feasibility and safety by the procedure. Results A total of 26 cases(ranging from 11 months to 3 years old, male 23 and female 3), 20 cases were diagnosed as unilateral inguinal hernia, 6 cases were diagnosed as bilateral inguinal hernias at pre-operation; while 17 cases were diagnosed as unilateral inguinal hernia, 9 cases were diagnosed as bilateral inguinal hernias during operation. There were 35 side hernias totally. Mean operating time for unilateral and bilateral inguinal hernia was (10.5±1.8) min and (19.6±2.1) min respectively. There were no complications intra-operative and all of the cases were discharged within 24 hours at post-operation. Follow-up for 9-12 months, there were no wound infection, iatrogenic
cryptorchidism or testicular atrophy and other complications, as well as recurrence hernia, hydrocele, suture granuloma formations. Conclusion It is safe, effective and convenient to apply the SPLPEC using an inner grappler with hernia ring ligation, which is useful for clinical treatment of inguinal hernia in children with invisible scarring of umbilical fossa.
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Received: 10 October 2018
Published: 26 July 2019
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