| Title |
Laparoscopic needle-assisted inguinal hernia repair in 495 children
|
|---|---|
| Published in |
Surgical Endoscopy, August 2014
|
| DOI | 10.1007/s00464-014-3739-8 |
| Pubmed ID | |
| Authors |
Lauren McClain, Christian Streck, Aaron Lesher, Robert Cina, Andre Hebra |
| Abstract |
Minimally invasive surgery for inguinal hernia repair in children has been a controversial topic for pediatric surgeons. Our method for inguinal hernia repair using laparoscopic techniques has comparable outcomes to the standard open technique. We describe our technique and experience with the laparoscopic needle-assisted repair of inguinal hernia (LNAR). We report 502 cases (710 hernias) from 2009 to 2013 by 3 surgeons. We reviewed our prospectively collected outcomes database of all patients receiving LNAR from 1/2009 to 3/2013. 502 cases in 495 patients <13 years old with 710 inguinal hernias were identified for analysis and review. Hernia repair is accomplished with a single-port needle-assisted technique. After identification of a patent processus vaginalis, the internal ring is encircled in an extraperitoneal plane using a 22G-Touhy needle for placement of a purse-string suture, tied extracorporally, and buried beneath the skin. The technique was standardized for all cases. 710 inguinal hernias were laparoscopically repaired in 495 patients (408 boys and 87 girls) age range 11 days to 12.8 years (mean 29.2 months; median 15.5 months). 294 patients had unilateral repair (199R and 95L) and 208 had bilateral repair. Mean operating time for unilateral was 20.5 min, and bilateral was 26.4 min. 21 minor complications were identified (9 superficial wound infections, 8 suture granulomas, and 4 recurrent hydroceles) and 4 recurrences. Mean time since surgery is 30 months (3-54 months). Mean follow-up was 10.7 months (0.3-38.4 months). Post-operative data show our technique is safe with a 4 % rate of minor complication. Recurrence rate was 0.56 % for the total number of hernias (4/710). This recurrence rate is comparable and in many cases less than open technique. Furthermore, laparoscopy objectively identifies asymptomatic or occult contralateral defect, uses a smaller incision, and eliminates dissection of the cord structures potentially reducing the risk of cord injury. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Science communicators (journalists, bloggers, editors) | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 50 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 2% |
| Unknown | 49 | 98% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 7 | 14% |
| Researcher | 6 | 12% |
| Student > Master | 6 | 12% |
| Student > Postgraduate | 4 | 8% |
| Professor > Associate Professor | 4 | 8% |
| Other | 10 | 20% |
| Unknown | 13 | 26% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 29 | 58% |
| Social Sciences | 2 | 4% |
| Computer Science | 2 | 4% |
| Biochemistry, Genetics and Molecular Biology | 1 | 2% |
| Nursing and Health Professions | 1 | 2% |
| Other | 1 | 2% |
| Unknown | 14 | 28% |
Attention Score in Context
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#17,749,774
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Outputs from Surgical Endoscopy
#4,372
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#155,493
of 230,597 outputs
Outputs of similar age from Surgical Endoscopy
#90
of 125 outputs
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