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Single-site laparoscopic percutaneous extraperitoneal closure of the inner ring utilizing an epidural and spinal needle: glorious leads to 1464 youngsters with inguinal hernia/hydrocele.
Surg Endosc. 2017 Jul;31(7):2932-2938
Authors: Wang F, Zhong H, Chen Y, Zhao J, Li Y, Chen J, Dong S
Summary
BACKGROUND: Laparoscopic percutaneous extraperitoneal closure (LPEC) of the inner ring is a well-developed process for pediatric inguinal hernia and hydrocele. To scale back the pores and skin incisions and enhance the cosmesis, single-site LPEC (SLPEC) has been developed with quite a few strategies and devices. On this research, we described our modifications of SLPEC utilizing an epidural and spinal needle in a big pediatric inhabitants.
METHODS: From February 2013 to February 2016, 1464 pediatric sufferers who underwent SLPEC in our hospital have been retrospectively reviewed. A 5-mm laparoscope was launched on the subumbilicus. An 18-gauge epidural needle with a silk suture loop was launched into the corresponding pores and skin of the inner ring. The needle was superior extraperitoneally on the medial aspect of the ring. The suture loop was pushed into peritoneal cavity by the spinal needle. The epidural needle was withdrawn to the roof of the inner ring after which stored advancing alongside the lateral aspect. Aided by the spinal needle and laparoscope, a protracted suture loop was despatched into the primary loop in peritoneal cavity. The lengthy suture loop was pulled out of the stomach wall by choosing up the primary loop, and the inner ring was closed by knotting the suture extracorporeally. The contralateral patent processus vaginalis (CPPV) was concurrently repaired if current.
RESULTS: In whole, 981 sufferers introduced with inguinal hernia and 483 with hydrocele. A CPPV was current in 483 sufferers with unilateral pathology and thus concurrently repaired. The hydrodissection method and greedy forceps have been utilized in 290 and 113 sufferers, respectively. The median operation time was 11 min (7-18 min) and 18 min (10-30 min) for unilateral and bilateral inguinal hernias/hydroceles, respectively. There was no improvement of intra- or postoperative problems.
CONCLUSIONS: SLPEC utilizing an epidural and spinal needle will be carried out with glorious leads to pediatric inguinal hernias and hydroceles.
PMID: 27815740 [PubMed – indexed for MEDLINE]