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Risteski T, Memeti S. Benefits of Contralateral Patent Processus Vaginalis Closure During Laparoscopic Surgery for Inguinal Hernia in Female Children. Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2022; 43:69-75. [PMID: 35843918 DOI: 10.2478/prilozi-2022-0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
After more than a decade, an accurate description of the current state of pediatric inguinal hernia repair still an issue of contention. Improvement of techniques together with patient-entered intervention that account for the experiences related to individual disease characteristics have become an important factor of which the surgeon must be aware. Therefore, the aim of this study is to analyze a potential treatment for metachronous contralateral inguinal hernia (MCIH) in children during laparoscopic assisted percutaneous internal inguinal ring suturing (PIRS). In a prospective clinical study, carried out at the University Clinic for Pediatric Surgery in Skopje, Republic of North Macedonia, we analyzed the data from 49 female children, aged 1-14 years old, with clinically diagnosed congenital inguinal hernia treated via PIRS. The position of hernias on the right side was 29 (59.2%) on the left side was 19 (38.8%) and on both sides was 1 (2.0%). With intraoperative assessment, it was determined that in 33 (67.3%) participants there was no presence of a hidden hernia, while in 16 (32.7%), there was indeed the presence of a hidden hernia. Of the hidden hernias determined laparoscopically [16 (100%)], 8 (50%) were left and right hidden hernias, all treated laparoscopically. The PIRS technique is a procedure where the basic advanced treatment is exploration. This also included the adequate treatment of other pathologies, such as the prophylactic closure of a contralateral patent processus vaginalis with simultaneous treatment as there is the potential for hernia in future, therefore reducing the number of metachronous inguinal hernias.
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Affiliation(s)
- Toni Risteski
- University Clinic for Pediatric Surgery, Faculty of Medicine, Ss. Cyril and Methodius, University in Skopje, RN Macedonia
| | - Shaban Memeti
- University Clinic for Pediatric Surgery, Faculty of Medicine, Ss. Cyril and Methodius, University in Skopje, RN Macedonia
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Lobe TE, Bianco FM. Adolescent inguinal hernia repair: a review of the literature and recommendations for selective management. Hernia 2022; 26:831-837. [PMID: 35028731 DOI: 10.1007/s10029-021-02551-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 12/19/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The choice of how to repair inguinal hernias in adolescents has historically been a matter of experience and differed between pediatric surgeons who traditionally performed a high ligation of the sac and general surgeons who typically perform a repair using mesh. This up-to-date review thoroughly examines the subject and discusses the suitability of both types of repairs in this unique age group. METHODS A 20-year Pub Med search was performed for the following terms: adolescent hernia repair including reports of mesh hernia repair in adolescents and postoperative complications including chronic inguinal pain and recurrences. RESULTS The evidence in the literature suggests that while there appears to be no difference between the two types of repairs with regards to recurrence and complications, changes in the pelvic floor physiology in adolescents suggest that a selective, individualized approach can be recommended depending on the size and nature of the presenting pathology. CONCLUSIONS A selective approach to the inguinal hernia in adolescent patients based on the size of the defect appears justified.
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Affiliation(s)
- T E Lobe
- Division of Pediatric Surgery, Department of Surgery, The University of Illinois, 840 S Wood Street, Ste 416, Chicago, IL, 60612, USA.
| | - F M Bianco
- Department of Surgery, The University of Illinois, Chicago, IL, USA
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Sullivan GA, Skertich NJ, Herberg R, Madonna MB, Pillai S, Shah AN, Gulack BC. Recurrence following laparoscopic repair of bilateral inguinal hernia in children under five. Am J Surg 2022; 224:1004-1008. [DOI: 10.1016/j.amjsurg.2022.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/25/2022] [Accepted: 04/13/2022] [Indexed: 11/01/2022]
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Igwe AO, Talabi AO, Adisa AO, Adumah CC, Ogundele IO, Sowande OA, Adejuyigbe O. Comparative Study of Laparoscopic and Open Inguinal Herniotomy in Children in Ile Ife, Nigeria: A Prospective Randomized Trial. J Laparoendosc Adv Surg Tech A 2019; 29:1609-1615. [DOI: 10.1089/lap.2019.0354] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Affiliation(s)
- Arua Obasi Igwe
- Pediatric Surgery Unit, Department of Surgery, Obafemi Awolowo University Teaching Hospital Complex, Ile Ife, Osun, Nigeria
| | - Ademola O. Talabi
- Pediatric Surgery Unit, Department of Surgery, Obafemi Awolowo University Teaching Hospital Complex, Ile Ife, Osun, Nigeria
| | - Adewale O. Adisa
- Pediatric Surgery Unit, Department of Surgery, Obafemi Awolowo University Teaching Hospital Complex, Ile Ife, Osun, Nigeria
| | - Collins C. Adumah
- Pediatric Surgery Unit, Department of Surgery, Obafemi Awolowo University Teaching Hospital Complex, Ile Ife, Osun, Nigeria
| | - Ibukun O. Ogundele
- Pediatric Surgery Unit, Department of Surgery, Obafemi Awolowo University Teaching Hospital Complex, Ile Ife, Osun, Nigeria
| | - Oludayo A. Sowande
- Pediatric Surgery Unit, Department of Surgery, Obafemi Awolowo University Teaching Hospital Complex, Ile Ife, Osun, Nigeria
| | - Olusanya Adejuyigbe
- Pediatric Surgery Unit, Department of Surgery, Obafemi Awolowo University Teaching Hospital Complex, Ile Ife, Osun, Nigeria
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Laparoscopic versus open inguinal hernia repair in children ≤3: a randomized controlled trial. Pediatr Surg Int 2017; 33:367-376. [PMID: 28025693 DOI: 10.1007/s00383-016-4029-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/30/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE Laparoscopy is being increasingly applied to pediatric inguinal hernia repair. In younger children, however, open repair remains preferred due to concerns related to anesthesia and technical challenges. We sought to assess outcomes after laparoscopic and open inguinal hernia repair in children less than or equal to 3 years. METHODS A prospective, single-blind, parallel group randomized controlled trial was conducted at three clinical sites. Children ≤3 years of age with reducible unilateral or bilateral inguinal hernias were randomized to laparoscopic herniorrhaphy (LH) or open herniorrhaphy (OH). The primary outcome was the number of acetaminophen doses. Secondary outcomes included operative time, complications, and parent/caregiver satisfaction scores. RESULTS Forty-one patients were randomized to unilateral OH (n = 10), unilateral LH (n = 17), bilateral OH (n = 5) and bilateral LH (n = 9). Acetaminophen doses, LOS, complications, and parent/caregiver scores did not differ among groups. Laparoscopic unilateral hernia repair demonstrated shorter operative time, a consistent finding for overall laparoscopic repair in univariate (p = 0.003) and multivariate (p = 0.010) analysis. No cases of testicular atrophy were documented at 2 (SD = 2.7) years. CONCLUSION Children ≤3 years of age in our cohort safely underwent LH with similar pain scores, complications, and recurrence as OH. Parents and caregivers report high satisfaction with both techniques.
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The efficacy of laparoscopic intracorporeal linear suture technique as a strategy for reducing recurrences in pediatric inguinal hernia. Hernia 2016; 21:425-433. [DOI: 10.1007/s10029-016-1546-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 11/12/2016] [Indexed: 10/20/2022]
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Thomas DT, Göcmen KB, Tulgar S, Boga I. Percutaneous internal ring suturing is a safe and effective method for the minimal invasive treatment of pediatric inguinal hernia: Experience with 250 cases. J Pediatr Surg 2016; 51:1330-5. [PMID: 26777889 DOI: 10.1016/j.jpedsurg.2015.11.024] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 10/04/2015] [Accepted: 11/29/2015] [Indexed: 01/13/2023]
Abstract
BACKGROUND/PURPOSE Percutaneous internal ring suturing (PIRS) is a minimally invasive method for repair of pediatric inguinal hernia. In this study we report our experience with PIRS. METHODS All children >10kg presenting to our institute between June 2013 and March 2015 with a diagnosis of indirect inguinal hernia or communicating hydrocele underwent laparoscopic repair using PIRS technique. Patients' gender, age at surgery, side of inguinal hernia/communicating hydrocele at diagnosis, peroperative findings, surgical and anesthesia times plus follow-up findings were collected. RESULTS Two-hundred thirteen patients underwent 250 procedures. Inguinal hernia or communicating hydrocele was diagnosed on the right side in 113 (53.1%), the left side in 75 (35.2%) and bilaterally in 25 patients (11.7%). Contralateral hernia was found in 35 patients (16.4%). Mean surgery time was 14.3min for unilateral and 20.4min for bilateral PIRS, and mean anesthesia time was 33.6min for unilateral and 39.1min for bilateral PIRS. Average follow-up time was 9.6months. Recurrence was seen in 3 (1.4%) and complications in 6 patients (2.8%). CONCLUSION PIRS is a simple, safe and effective method for the treatment of inguinal hernia and communicating hydrocele in children.
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Affiliation(s)
| | - Kamil Basar Göcmen
- Pendik State Hospital, Department of Pediatric Surgery, Istanbul, Turkey
| | - Serkan Tulgar
- Pendik State Hospital, Department of Anesthesiology & Reanimation, Istanbul, Turkey
| | - Ibrahim Boga
- Pendik State Hospital, Department of Anesthesiology & Reanimation, Istanbul, Turkey
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Steven M, Carson P, Bell S, Ward R, McHoney M. Simple Purse String Laparoscopic Versus Open Hernia Repair. J Laparoendosc Adv Surg Tech A 2016; 26:144-7. [DOI: 10.1089/lap.2014.0276] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mairi Steven
- Department of Paediatric Surgery, Royal Hospital for Sick Children, Edinburgh, Scotland, United Kingdom
| | - Peter Carson
- Department of Paediatric Surgery, Royal Hospital for Sick Children, Edinburgh, Scotland, United Kingdom
| | - Stephen Bell
- Department of Paediatric Surgery, Royal Hospital for Sick Children, Edinburgh, Scotland, United Kingdom
| | - Rebecca Ward
- Department of Paediatric Surgery, Royal Hospital for Sick Children, Edinburgh, Scotland, United Kingdom
| | - Merrill McHoney
- Department of Paediatric Surgery, Royal Hospital for Sick Children, Edinburgh, Scotland, United Kingdom
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Lee DY, Baik YH, Kwak BS, Oh MG, Choi WY. A purse-string suture at the level of internal inguinal ring, taking only the peritoneum leaving the distal sac: is it enough for inguinal hernia in pediatric patients? Hernia 2015; 19:607-10. [PMID: 25644487 DOI: 10.1007/s10029-015-1348-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 01/17/2015] [Indexed: 01/28/2023]
Abstract
PURPOSE Although laparoscopic surgery in children has expanded in recent years. Laparoscopic hernia repair in children is still debatable. We aimed to summarize and describe our results of laparoscopic inguinal hernia repair and techniques among children. METHODS Between March 2011 and April 2013, 98 children (67 male, 31 female) underwent laparoscopic inguinal hernia repair at the department of surgery. The clinical outcomes were collected retrospectively. RESULTS The mean follow-up period was 22.6 months. Twelve patients were ex-premature infants and a contralateral patent processus vaginalis (PPV) was present in 37 of the 91 unilateral inguinal hernia patients. There were two postoperative complications (transient hydrocele, umbilical port site infection). The mean operative time was 46 min. Recurrence, metachronous hernia and testicular atrophy were not observed during the follow-up period. CONCLUSIONS Our preliminary experiences suggest that the laparoscopic purse-string suture of internal inguinal opening of hernia sac could be a safe, effective, and reliable alternative for management of pediatric inguinal hernia.
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Affiliation(s)
- D Y Lee
- Department of Surgery, College of Medicine, Dongguk University, Seoul, South Korea
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Rich BS, Creasy J, Afaneh C, Muensterer OJ. The international experience of single-incision pediatric endosurgery: current state of the art. J Laparoendosc Adv Surg Tech A 2013; 24:43-9. [PMID: 24147902 DOI: 10.1089/lap.2013.0294] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
PURPOSE As application and awareness of single-incision pediatric endosurgery (SIPES) are increasing, various techniques and indications have been independently described by select centers around the world. In order to facilitate a cooperative approach toward advancing and investigating the practice of SIPES, we conducted a survey among members of the International Pediatric Endosurgery Group (IPEG), asking them about their experience and attitudes toward single-incision endosurgery. MATERIALS AND METHODS After institutional review board approval, an invitation to participate in an online survey was sent to all IPEG members. Questions focused on demographic information, practice patterns, indications, and equipment used regarding SIPES. RESULTS Of the 560 contacted active IPEG members, 115 completed the survey (recall 21%). The respondents represented pediatric surgeons from 32 countries on six continents. Of respondents, 97% had heard of, while 71% had performed, SIPES. Reasons for not having performed SIPES included disbelief in benefit (59%), lack of proficiency (34%), and inadequate resources (28%). The most commonly performed SIPES procedures were appendectomy (85%), cholecystectomy (66%), splenectomy (42%), pyloromyotomy (35%), and intestinal surgery (13%), as well as Nissen fundoplication and gynecologic adnexal pathology (7%). The equipment and techniques utilized showed large variation and included some self-devised, innovative, low-resource approaches. Complications with SIPES reported by the survey participants included technical difficulties, wound infection, and prolonged operating time. CONCLUSIONS SIPES is being performed worldwide for a large spectrum of common indications in pediatric surgery. The equipment and techniques used vary with geographic location and resources. Some encountered complications are common to those seen with conventional minimally invasive surgery, whereas others may be SIPES-specific. Different respondents reported diverging views on pain, operating time, and cost.
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Affiliation(s)
- Barrie S Rich
- 1 Division of Pediatric Surgery, Weill Cornell Medical College , New York, New York
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