Skip to main content
SpringerLink
Log in

Single-port laparoscopic percutaneous double ligation for pediatric inguinal hernias: report of a new technique and early results

  • Original Article
  • Published:
Hernia Aims and scope Submit manuscript

Abstract

Purpose

Several single-port laparoscopic hernial repair methods have been designed to treat inguinal hernia in children, but reliable and safe ligation of the hernial sac should be further investigated. This study aimed to investigate a new technique for laparoscopic percutaneous double ligation for pediatric inguinal hernias with a set of home-made instruments.

Methods

Before each operation, a set of home-made instruments were prepared, including a curved puncture needle, a lasso suture, a dual ligation suture, and occasionally, a flat-headed puncture needle for obese patients. After a series of operational steps, the hernial sac was doubly extracorporeally ligated, leaving only one puncture point in the inguinal region and one incision in the navel.

Results

Between October 2011 and September 2013, 236 children (211 boys and 25 girls) underwent hernial repair using this novel technique. In 38.8 % (85/219) of patients with the preoperative diagnosis of unilateral inguinal hernia, contralateral patent processus vaginalis was confirmed during the laparoscopic surgery and subsequent repair was performed. In 134 cases of unilateral repair, the mean operative time was 11 min (range 5–16 min), and it was 19 min (range 13–29 min) in 102 cases of bilateral repair. No recurrence or complications have been observed to date.

Conclusions

This study shows a unique technique of percutaneous double ligation of the hernial sac using a minimally invasive technique with the aid of a transabdominal 5-mm telescope and a set of home-made instruments. Single-port laparoscopic hernial repair using this technique is feasible and appears to be safe.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Bharathi RS, Arora M, Baskaran V (2008) Minimal access surgery of pediatric inguinal hernias: a review. Surg Endosc 22:1751–1762

    Article  Google Scholar 

  2. Chang YT (2010) Technical refinements in single port laparoscopic surgery of inguinal hernia in infants and children. Diagn Ther Endosc 2010:392847

    Article  PubMed  PubMed Central  Google Scholar 

  3. Harrison MR, Lee H, Albanese CT, Farmer DL (2005) Subcutaneous endoscopically assisted ligation (SEAL) of the internal ring for repair of inguinal hernias in children: a novel technique. J Pediatr Surg 40:1177–1180

    Article  PubMed  Google Scholar 

  4. Ozgediz D, Roayaie K, Lee H et al (2007) Subcutaneous endoscopically assisted ligation (SEAL) of the internal ring for repair of inguinal hernias in children: report of a new technique and early results. Surg Endosc 21:1327–1331

    Article  CAS  PubMed  Google Scholar 

  5. Patkowski D, Czernik J, Chrzan R et al (2006) Percutaneous internal ring suturing: a simple minimally invasive technique for inguinal hernia repair in children. J Laparoendosc Adv Surg Tech 16:513–517

    Article  Google Scholar 

  6. Chang YT, Wang JY, Lee JY et al (2008) One-trocar laparoscopic transperitoneal closure of inguinal hernia in children. World J Surg 32:2459–2463

    Article  PubMed  Google Scholar 

  7. Chang YT, Wang JY, Lee JY, Chiou CS (2009) A simple single-port laparoscopic-assisted technique for completely enclosing inguinal hernia in children. Am J Surg 198(1):e13–e16

    Article  PubMed  Google Scholar 

  8. Li B, Nie X, Xie H, Gong D (2012) Modified single-port laparoscopic herniorrhaphy for pediatric inguinal hernias: based on 1,107 cases in China. Surg Endosc 26(12):3663–3668

    Article  PubMed  Google Scholar 

  9. Liu W, Wu R, Du G (2014) Single-port laparoscopic extraperitoneal repair of pediatric inguinal hernias and hydroceles by using modified Kirschner pin: a novel technique. Hernia 18(3):345–349

    Article  CAS  PubMed  Google Scholar 

  10. Tsai YC, Wu CC, Yang SS (2007) Minilaparoscopic herniorrhaphy with hernia sac transection in children and young adults: a preliminary report. Surg Endosc 21:1623–1625

    Article  PubMed  Google Scholar 

  11. Chan KL, Chan HY, Tam PK (2007) Towards a near-zero recurrence rate in laparoscopic inguinal hernia repair for pediatric patients of all ages. J Pediatr Surg 42:1993–1997

    Article  PubMed  Google Scholar 

  12. Tatekawa Y (2012) Laparoscopic extracorporeal ligation of hernia defects using an epidural needle and preperitoneal hydrodissection. J Endourol 26(5):474–477

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatric Surgery, Qilu Hospital, Shandong University, 106 Wenhua Xi Road, Jinan, 250012, China

    Z. Cui & W. Zhang

  2. Department of Pediatric Surgery, Linyi People’s Hospital, Shandong University, 27 Jiefang Road, Linyi, 276003, China

    Z. Cui, Y. Liu & F. Sun

Authors
  1. Z. Cui
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Y. Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. W. Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. F. Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Y. Liu.

Ethics declarations

Conflict of interest

Zhengmin Cui,Yu Liu, Wentong Zhang, and Futao Sun declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cui, Z., Liu, Y., Zhang, W. et al. Single-port laparoscopic percutaneous double ligation for pediatric inguinal hernias: report of a new technique and early results. Hernia 20, 579–584 (2016). https://doi.org/10.1007/s10029-015-1404-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10029-015-1404-3

Keywords

Search

Navigation