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Laparoscopic totally extraperitoneal ligation for pediatric inguinal hernia: a novel surgical treatment

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Abstract

Background

Laparoscopic repair is widely performed for the management of pediatric inguinal hernia (PIH), and different laparoscopic surgical methods are used. Herein, we present the application of laparoscopic totally extraperitoneal ligation (TEPL), which is a novel surgical method for PIH repair and is similar to traditional high ligation.

Methods

In this study, 103 pediatric patients underwent laparoscopic TEPL for inguinal hernia. Data including demographic characteristics, clinical presentation, time of surgery, length of hospital stay, and postoperative complications were analyzed retrospectively.

Results

The patient’s median age at surgery was 4.3 years, and the median body weight at surgery was 18 kg. The preoperative diagnoses were as follows: n = 53, right inguinal hernia; n = 45, left inguinal hernia; and n = 5, bilateral inguinal hernia. All patients were discharged on the day of surgery. The operative times were 27.2 min for unilateral inguinal hernia and 28.8 min for bilateral inguinal hernia. All patients, except one who had scrotal bruise, did not present with postoperative complications.

Conclusions

Laparoscopic TEPL, which is similar to traditional high ligation, is used for the treatment of PIH. Moreover, it is safe, beneficial, and feasible. Double ligation is performed on the extraperitoneal space, and the assessment of contralateral patent processus vaginalis is not complex. However, further studies should be conducted to assess for long-term outcomes.

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References

  1. Snyder CL, Escolino M, Esposito C (2020) Inguinal hernia. In: Holcomb GW III, Murphy JP, St Peter SD (eds) Holcomb and Ashcraft’s pediatric surgery, 7th edn. Elsevier, China, pp 784–804

    Google Scholar 

  2. Read RC (2009) Herniology: past, present, and future. Hernia 13:577–580

    Article  CAS  Google Scholar 

  3. Smith AK, Speck KE (2018) Pediatric laparoscopic inguinal hernia repair: a review of techniques. SAGES, https://www.sages.org/wiki/pediatric-laparoscopic-inguinal-hernia-repair-a-review-of-techniques/. Accessed 23 Feb 2021

  4. Johnson J, Roth JS, Hazey JW, Pofahl WE (2004) The history of open inguinal hernia repair. Curr Surg 61:49–52

    Article  Google Scholar 

  5. Schier F (2006) Laparoscopic inguinal hernia repair—a prospective personal series of 542 children. J Pediatr Surg 41:1081–1084

    Article  Google Scholar 

  6. Becmeur F, Philippe P, Lemandat-Schultz A, Moog R, Grandadam S, Lieber A, Toledano D (2004) A continuous series of 96 laparoscopic inguinal hernia repairs in children by a new technique. Surg Endosc 18:1738–1741

    Article  CAS  Google Scholar 

  7. Spurbeck WW, Prasad R, Lobe TE (2005) Two-year experience with minimally invasive herniorrhaphy in children. Surg Endosc 19:551–553

    Article  CAS  Google Scholar 

  8. Takehara H, Yakabe S, Kameoka K (2006) Laparoscopic percutaneous extraperitoneal closure for inguinal hernia in children: clinical outcome of 972 repairs done in 3 pediatric surgical institutions. J Pediatr Surg 41:1999–2003

    Article  Google Scholar 

  9. Esposito C, Escolino M, Farina A, Settimi A (2014) Two decades of history of laparoscopic pediatric inguinal hernia repair. J Laparoendosc Adv Surg Tech A 24:669–670

    Article  Google Scholar 

  10. Esposito C, Escolino M, Turra F, Roberti A, Cerulo M, Farina A, Caiazzo S, Cortese G, Servillo G, Settimi A (2016) Current concepts in the management of inguinal hernia and hydrocele in pediatric patients in laparoscopic era. Semin Pediatr Surg 25:232–240

    Article  Google Scholar 

  11. Montupet P, Esposito C (1999) Laparoscopic treatment of congenital inguinal hernia in children. J Pediatr Surg 34:420–423

    Article  CAS  Google Scholar 

  12. Schier F (2000) Laparoscopic surgery of inguinal hernias in children—initial experience. J Pediatr Surg 35:1331–1335

    Article  CAS  Google Scholar 

  13. Parelkar SV, Oak S, Gupta R, Sanghvi B, Shimoga PH, Kaltari D, Prakash A, Shekhar R, Gupta A, Bachani M (2010) Laparoscopic inguinal hernia repair in the pediatric age group—experience with 437 children. J Pediatr Surg 45:789–792

    Article  Google Scholar 

  14. McKernan JB, Laws HL (1993) Laparoscopic repair of inguinal hernias using a totally extraperitoneal prosthetic approach. Surg Endosc 7:26–28

    Article  CAS  Google Scholar 

  15. Aiolfi A, Cavalli M, Micheletto G, Lombardo F, Bonitta G, Morlacchi A, Bruni PG, Campanelli G, Bona D (2019) Primary inguinal hernia: systematic review and Bayesian network meta-analysis comparing open, laparoscopic transabdominal preperitoneal, totally extraperitoneal, and robotic preperitoneal repair. Hernia 23:473–484

    Article  CAS  Google Scholar 

  16. Li Y, Wu Y, Wang C, Wang Q, Zhao Y, Ji Y, Xiang B (2019) Incidence of pediatric metachronous contralateral inguinal hernia and the relationship with contralateral patent processus vaginalis. Surg Endosc 33:1087–1090

    Article  Google Scholar 

  17. Zhong H, Wang F (2014) Contralateral metachronous hernia following negative laparoscopic evaluation for contralateral patent processus vaginalis: a meta-analysis. J Laparoendosc Adv Surg Tech A 24:111–116

    Article  Google Scholar 

  18. Karabulut B (2011) One surgeon experiences in childhood inguinal hernias. J Korean Surg Soc 81:50–53

    Article  Google Scholar 

  19. Bittner R, Arregui ME, Bisgaard T, Dudai M, Ferzli GS, Fitzgibbons RJ, Fortelny RH, Klinge U, Kockerling F, Kuhry E, Kukleta J, Lomanto D, Misra MC, Montgomery A, Morales-Conde S, Reinpold W, Rosenberg J, Sauerland S, Schgu-Paß C, Singh K, Timoney M, Weyhe D, Chowbey P (2011) Guidelines for laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia [International Endohernia Society(IEHS)]. Surg Endosc 25:2773–2843

    Article  CAS  Google Scholar 

  20. Stylianidis G, Haapamaki MM, Sund M, Nilsson E, Nordin P (2010) Management of the hernial sac in inguinal hernia repair. Br J Surg 97:415–419

    Article  CAS  Google Scholar 

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Acknowledgements

Thanks to RN Jaesoon Park and Jihee Yun for organizing data.

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Authors and Affiliations

  1. Department of Pediatric Surgery, Keimyung University School of Medicine, Daegu, Republic of Korea

    Eun-jung Koo

  2. Department of Pediatric Surgery, Keimyung University Dongsan Medical Center, 1095 Dalgubeol-daero, Dalseo-gu, Daegu, 42601, Republic of Korea

    Eunyoung Jung

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  1. Eun-jung Koo
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Correspondence to Eunyoung Jung.

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Eun-jung Koo and Eunyoung Jung have no conflicts of interest or financial ties to disclose.

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Koo, Ej., Jung, E. Laparoscopic totally extraperitoneal ligation for pediatric inguinal hernia: a novel surgical treatment. Surg Endosc 36, 1320–1325 (2022). https://doi.org/10.1007/s00464-021-08408-y

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