FIRST EXPERIENCES WITH LAPAROSCOPIC HERNIOPLASTY IN THE TREATMENT OF INDIRECT INGUINAL HERNIAS IN FEMALE CHILDREN
Date Issued
2018
Author(s)
Risto Simeonov
Abstract
Introduction: Inguinal hernia is one of the most performed operations in pediatric surgery, and it is the most common reason for consulting a pediatric surgeon. The incidence of indirect inguinal hernia in children is 0.8-4.4%. There are more operative methods of open surgical and minimally invasive laparoscopic techniques. Aim: The aim of this study is to identify the descriptive characteristics of the initial cases of applying a laparoscopic hernia repair technique for the treatment of female children diagnosed with congenital indirect inguinal hernia.
Materials and method: This is a descriptive study with collected clinical data from the University Clinic of Pediatric Surgery in Skopje. The sample, collected in the period 2015-16, covers a total of ten girls aged 0-14 years, who were clinically diagnosed with indirect inguinal hernia.The patients underwent PIRS(percutaneous internal ring suturing) techique.Results: The average age of the patients was 68,3 ± 34,2 months with a minimum of 24 and maximum of 168 months. According to the location of the inguinal hernia, in 7 (70%) patients it was right-sided, in 2 (20%) it was left-sided, and in 1 (10%) it was bilateral. During the laparoscopic exploration of the inguinal hernia repair there was an incidental finding of two contralateral occult inguinal hernias that were sutured with the same technique in a single act. In 50% of the patients the intervention lasted less than 25 (23-31) minutes. The length of the hospital stay was 10,8 ± 3,1 hours. The shortest hospital stay was 8 hours and the longest 16 hours. Fifty percent of the children took up a sitting position in bed in less than 4 hours. The average time for taking up a sitting position was 4,1 ± 0,9 hours with a minimum of 3 and maximum of 6 hours. Post-operative analgesia single dose was given to only 2 (20%) of the children. The length of the surgical scar in 50% of the children is less than 2mm. During the 6 month post-operative follow-up period, there were no recurrent findings of hernia in any of the cases. Conclusion:The laparoscopic technique of percutaneous closure of the internal inguinal ring in the treatment of inguinal hernia in female children is a minimally invasive procedure with preferable advantages in terms of reduced post-operative pain, reduced hospital stay, rapid return to normal activities as well as an excellent cosmetic effect.
Materials and method: This is a descriptive study with collected clinical data from the University Clinic of Pediatric Surgery in Skopje. The sample, collected in the period 2015-16, covers a total of ten girls aged 0-14 years, who were clinically diagnosed with indirect inguinal hernia.The patients underwent PIRS(percutaneous internal ring suturing) techique.Results: The average age of the patients was 68,3 ± 34,2 months with a minimum of 24 and maximum of 168 months. According to the location of the inguinal hernia, in 7 (70%) patients it was right-sided, in 2 (20%) it was left-sided, and in 1 (10%) it was bilateral. During the laparoscopic exploration of the inguinal hernia repair there was an incidental finding of two contralateral occult inguinal hernias that were sutured with the same technique in a single act. In 50% of the patients the intervention lasted less than 25 (23-31) minutes. The length of the hospital stay was 10,8 ± 3,1 hours. The shortest hospital stay was 8 hours and the longest 16 hours. Fifty percent of the children took up a sitting position in bed in less than 4 hours. The average time for taking up a sitting position was 4,1 ± 0,9 hours with a minimum of 3 and maximum of 6 hours. Post-operative analgesia single dose was given to only 2 (20%) of the children. The length of the surgical scar in 50% of the children is less than 2mm. During the 6 month post-operative follow-up period, there were no recurrent findings of hernia in any of the cases. Conclusion:The laparoscopic technique of percutaneous closure of the internal inguinal ring in the treatment of inguinal hernia in female children is a minimally invasive procedure with preferable advantages in terms of reduced post-operative pain, reduced hospital stay, rapid return to normal activities as well as an excellent cosmetic effect.
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